Search PubMed⌕ Search

Biomedical subjects

K Hassanein

Publications and source records attributed to K Hassanein.

At least 19 recordsLinked to original sources
PubMed2002

Recurrent neck disease in oral cancer.

PURPOSE: The goals were to examine the clinical and pathologic features of patients who developed metastatic squamous cell carcinoma in the cervical lymph nodes after initial treatment and to identify any common patterns. PATIENTS AND METHODS: A retrospective analysis of 35 patients of varying initial tumor stage was performed. There were 18 patients who had an initial neck dissection and 17 patients whose neck was managed by a "watch and wait" policy. RESULTS: Recurrence frequently involved level II nodes, and extracapsular spread was invariably present. The time taken for recurrence to develop was the same in both groups of patients (15 months, P =.35), and the overall median survival time after recurrence was 18 months (12 to 25 months, 95% confidence interval). In 27 of 29 patients (93%) who had the primary tumor resected, the thickness of tumor was greater than 5 mm. CONCLUSION: Neck recurrence may represent residual disease; it has histologically unfavorable features and consequently a poor prognosis. The frequency of recurrence at level II emphasizes the need for meticulous dissection in this region, and tumor thickness needs to be considered in planning treatment of the clinically negative neck.

Carcinoma, Squamous Cell↗
PubMed2000

Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy.

OBJECTIVES: To determine the clinical benefit of dextrose prolotherapy (injection of growth factors or growth factor stimulators) in osteoarthritic finger joints. DESIGN: Prospective randomized double-blind placebo-controlled trial. SETTINGS/LOCATION: Outpatient physical medicine clinic. SUBJECTS: Six months of pain history was required in each joint studied as well as one of the following: grade 2 or 3 osteophyte, grade 2 or 3 joint narrowing, or grade 1 osteophyte plus grade 1 joint narrowing. Distal interphalangeal (DIP), proximal interphalangeal (PIP), and trapeziometacarpal (thumb CMC) joints were eligible. Thirteen patients (with seventy-four symptomatic osteoarthitic joints) received active treatment, and fourteen patients (with seventy-six symptomatic osteoarthritic joints) served as controls. INTERVENTION: One half milliliter (0.5 mL) of either 10% dextrose and 0.075% xylocaine in bacteriostatic water (active solution) or 0.075% xylocaine in bacteriostatic water (control solution) was injected on medial and lateral aspects of each affected joint. This was done at 0, 2, and 4 months with assessment at 6 months after first injection. OUTCOME MEASURES: One-hundred millimeter (100 mm) Visual Analogue Scale (VAS) for pain at rest, pain with joint movement and pain with grip, and goniometrically-measured joint flexion. RESULTS: Pain at rest and with grip improved more in the dextrose group but not significantly. Improvement in pain with movement of fingers improved significantly more in the dextrose group (42% versus 15% with a p value of .027). Flexion range of motion improved more in the dextrose group (p = .003). Side effects were minimal. CONCLUSION: Dextrose prolotherapy was clinically effective and safe in the treatment of pain with joint movement and range limitation in osteoarthritic finger joints.

Double-Blind Method↗
PubMed2000

Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity.

CONTEXT: Use of prolotherapy (injection of growth factors or growth factor stimulators). OBJECTIVE: Determine the effects of dextrose prolotherapy on knee osteoarthritis with or without anterior cruciate ligament (ACL) laxity. DESIGN: Prospective randomized double-blind placebo-controlled trial. SETTING: Outpatient physical medicine clinic. PATIENTS OR OTHER PARTICIPANTS: Six months or more of pain along with either grade 2 or more joint narrowing or grade 2 or more osteophytic change in any knee compartment. A total of 38 knees were completely void of cartilage radiographically in at least 1 compartment. INTERVENTION: Three bimonthly injections of 9 cc of either 10% dextrose and .075% lidocaine in bacteriostatic water (active solution) versus an identical control solution absent 10% dextrose. The dextrose-treated joints then received 3 further bimonthly injections of 10% dextrose in open-label fashion. MAIN OUTCOME MEASURES: Visual analogue scale for pain and swelling, frequency of leg buckling, goniometrically measured flexion, radiographic measures of joint narrowing and osteophytosis, and KT1000-measured anterior displacement difference (ADD). RESULTS: All knees: Hotelling multivariate analysis of paired observations between 0 and 6 months for pain, swelling, buckling episodes, and knee flexion range revealed significantly more benefit from the dextrose injection (P = .015). By 12 months (6 injections) the dextrose-treated knees improved in pain (44% decrease), swelling complaints (63% decrease), knee buckling frequency (85% decrease), and in flexion range (14 degree increase). Analysis of blinded radiographic readings of 0- and 12-month films revealed stability of all radiographic variables except for 2 variables which improved with statistical significance. (Lateral patellofemoral cartilage thickness [P = .019] and distal femur width in mm [P = .021]. Knees with ACL laxity: 6-month (3 injection) data revealed no significant improvement. However, Hotelling multivariate analysis of paired values at 0 and 12 months for pain, swelling, joint flexion, and joint laxity in the dextrose-treated knees, revealed a statistically significant improvement (P = .021). Individual paired t tests indicated that blinded measurement of goniometric knee flexion range improved by 12.8 degrees (P = .005), and ADD improved by 57% (P = .025). Eight out of 13 dextrose-treated knees with ACL laxity were no longer lax at the conclusion of 1 year. CONCLUSION: Prolotherapy injection with 10% dextrose resulted in clinically and statistically significant improvements in knee osteoarthritis. Preliminary blinded radiographic readings (1-year films, with 3-year total follow-up period planned) demonstrated improvement in several measures of osteoarthritis severity. ACL laxity, when present in these osteoarthritic patients, improved.

Anterior Cruciate Ligament↗
PubMed1997

Joint moments in minor limb length discrepancy: a pilot study.

A biomechanical analysis was performed to determine if a minor limb length discrepancy alters lower extremity joint mechanics significantly and in a manner that could contribute to the development of joint abnormalities. Ten healthy subjects with equal limb lengths were recruited. Gait analysis was performed for both left and right sides to determine the maximum moments at the hip, knee, and ankle joints. A minor limb length discrepancy was simulated by adding a shoe lift of 1.25 cm to the left leg. After a period of acclimation, the gait was reanalyzed. Differences for maximum joint moments at the hip, knee, and ankle before and after simulation were nonsignificant. An additional 10 healthy, asymptomatic patients with actual limb length discrepancies ranging from 1 cm to 2 cm were also recruited. Gait analysis for maximum joint moments before and after correction of the limb length discrepancy was performed. Side-to-side differences in joint moments before correction were nonsignificant. After correction of the limb length discrepancy, side-to-side joint moment differences were significantly increased (P = 0.02) and may suggest acute overcompensation to the presence of the corrective shoe lift. Consequently, this study did not find an association between minor limb length discrepancies and predictable changes in lower extremity joint kinetics that might potentially lead to joint abnormalities.

Adolescent↗
PubMed1994

Low dose cyclosporin-A therapy in Behçet's disease.

The effect of systemic low dose cyclosporin-A (5 mg/kg/day as initial dose) combined with 0.2 to 0.6 mg/kg/day prednisolone (when necessary) in clinical course of 22 patients suffering from severe forms of Behçet's disease are reviewed. All the patients had received other drugs previously and had either no response to them or developed intolerable side effects, therefore, pre treatment visual acuity (VA) was compared to post treatment VA as "self control". The average age of our patients was 30.6 years (range 19-51 years). The average duration of our therapy was 19.5 months (range 4-32 months). Improvement or stabilization of vision was achieved in 21 patients (95%). The intraocular inflammation was controlled in all of the eyes and most of the non-ocular signs and symptoms were also improved. Serious side effects included rise in creatinine in 10 (45%) of the patients, rise in bilirubin in 6 (27%) and hypertension in 1 (4.5%). These side effects disappeared as the dose of cyclosporin-A was tapered. We believe this form of therapy is of great value in the management of severe forms of Behçet's disease.

Administration, Oral↗
PubMed1993

The effect of corneal thickness on applanation tonometry.

Simultaneous manometry and Perkins tonometry were performed at 10.0, 20.0, and 30.0 mm Hg on 15 eyes on which intraocular procedures were performed. There was a statistically significant relationship between corneal thickness and the error of Perkins tonometry. Thin corneas produced underestimations of the intraocular pressure by as much as 4.9 mm Hg, whereas thick corneas produced overestimations by as much as 6.8 mm Hg. Measuring the corneal thickness is necessary to interpret properly the results of Goldmann applanation tonometry, particularly in eyes with thin corneas.

Anthropometry↗
PubMed1992

Effect of buckling material on ocular rigidity.

Enucleated human eyes were banded with metal and silicone bands to produce reductions in their diameter of 2 mm and 4 mm. The ocular rigidity produced by each banding material at each diameter was measured in the pressure range of 10 mmHg to 40 mmHg. Metal bands produced mild reductions in ocular rigidity that were significantly (P less than 0.05 to 0.01) lower than the control ocular rigidities in some pressure ranges. Silicone bands produced large reductions in ocular rigidity that were significantly (P less than 0.01) lower than ocular rigidities observed in metal-banded or control conditions in all pressure ranges. The influence of the elastic silicone banding material on ocular rigidity was greater than the influence of altered shape and wall stress that occurred with metal banding.

Aged↗
PubMed1991

The effect of Perkins, Tono-Pen, and Schiötz tonometry on intraocular pressure.

We studied the intraocular pressure changes produced in five eye bank eyes by Perkins, Tono-Pen, and Schiötz tonometry performed by experienced and inexperienced personnel. When all users were considered together, Perkins tonometry produced a mean intraocular pressure increase of 0.7 mm Hg, significantly less than the mean increase of 12.1 mm Hg produced by Tono-Pen tonometry (P less than .05) or the mean increase of 16.5 mm Hg produced by Schiötz tonometry (P less than .01). There was no statistically significant difference between the intraocular pressure increase produced by Tono-Pen or Schiötz tonometry. Tonometry performed by inexperienced Tono-Pen users and experienced or inexperienced Schiötz users produced a significantly greater increase in intraocular pressure than that performed by experienced Tono-Pen users (P less than .05), and an extremely significant increase compared to tonometry performed by experienced or inexperienced Perkins users (P less than .01). The marked increase in intraocular pressure produced by Tono-Pen tonometry suggests that hand-held electronic applanation tonometers should be used with caution in eyes with a weakened cornea or sclera.

Humans↗
PubMed1991

Low-intensity anticoagulation in mechanical cardiac prosthetic valves.

Retrospectively, we reviewed the charts of 101 patients at the University of Kansas Medical Center who received low-intensity anticoagulation for mechanical prosthetic valves implanted over a 17-yr period. The mean duration of follow-up was 4.6 yr, and the total duration of follow-up was 466.5 patient-yr. The patients' records were evaluated for evidence of hemorrhagic or thromboembolic complications. A prothrombin time ratio of 1.3 to 1.5 times control was considered to be low-intensity anticoagulation. There were three thromboembolic events or 2.9/100 patient-yr of follow-up at a prothrombin time ratio of less than 1.3, four thromboembolic events or 2.5/100 patient-yr of follow-up at 1.3 to 1.5 times control, four thromboembolic events or 2.2/100 patient-yr of follow-up at 1.6 to 2.0 times control, and no thromboembolic events at prothrombin time ratios greater than 2.0 times control. Hemorrhagic events occurred in three patients at a prothrombin time ratio of less than 1.3 times control or 2.8/100 patient-yr of follow-up, in six patients at 1.3 to 1.5 times control or 3.8/100 patient-yr of follow-up, in ten patients at 1.6 to 2.0 times control or 5.5/100 patient-yr of followup, and in two patients at 2.1 to 2.5 times control or 12.2/100 patient-yr of follow-up. The rate of hemorrhagic events at 2.5 times control was 470/100 patient-yr follow-up. While not providing definitive proof, we believe that our retrospective study provides supportive evidence for the use of low-intensity anticoagulation in patients with mechanical cardiac prostheses.

Adult↗
PubMed1990

Relationship of age to histologic grade in prostate cancer.

We studied 4,968 cases of prostatic carcinoma to determine if there is a relationship between tumor grade and patient age at diagnosis. Cases were stratified into arbitrary age groups and classified as either better differentiated (Grades I and II) or worse differentiated (Grades III and IV). The 4,596 graded cases were distributed by stage as follows: Local 3,451 (75%), Regional 509 (11%), and Distant 636 (14%). When patients in all stages were considered together, the percentage of men with better differentiated tumors dropped from 77.8% of patients under 60 to 67.5% of patients 80 or older (P less than 0.00001). This trend for older patients to have more poorly differentiated tumors was also seen in patients with localized disease (P less than 0.0005). The fact that occult, biologically inactive prostate cancer is common in older men has led some to extrapolate that clinically apparent disease follows a more benign course in the elderly. Our findings suggest that, on the contrary, elderly men with clinically apparent disease have worse differentiated tumors than their younger counterparts.

Age Factors↗
PubMed1989

Comparison of droperidol 0.01 mg/kg and 0.005 mg/kg as a premedication in the prevention of nausea and vomiting in the outpatient for laparoscopy.

Patients undergoing outpatient laparoscopy and general anesthesia have a high incidence of postoperative nausea and vomiting. It is essential that anesthesia techniques accommodate the special needs of these outpatients. Droperidol is an effective antiemetic but larger doses above 1-1.25 mg may cause unwanted side effects which may prolong recovery and discharge. The current trend is to decrease the dose of droperidol to prevent side effects while still retaining the antiemetic properties. This experimental study compares droperidol 0.010 mg/kg and 0.005 mg/kg as a premedication for the prevention of nausea and vomiting in 32 female outpatients undergoing laparoscopy and general anesthesia. The patients were randomized into two groups. Group I received droperidol 0.010 mg/kg and Group II received 0.005 mg/kg as a preoperative antiemetic in double-blind fashion. Both groups received the same anesthetic for induction and maintenance of anesthesia. The patients were observed in the postanesthesia room for the incidence of nausea and vomiting. They were transported to the outpatient department and were also observed for nausea and vomiting. The t-test was used to show that there were no significant differences between groups in population characteristics. Chi-square analysis was used to determine statistical significance in the incidence of nausea or vomiting between the two groups. Analysis showed there was no statistically significant difference in the incidence of nausea or vomiting in the postanesthesia room or the outpatient department, although there was a significant clinical difference between the groups especially in the incidence of nausea in the outpatient department.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Hemodynamic effects of dopexamine hydrochloride infusions of 48 to 72 hours' duration for severe congestive heart failure.

Dopexamine hydrochloride, a new dopaminergic derivative with potent beta 2-agonist activity, was administered to 10 patients with severe congestive heart failure. Initially, the drug was infused at increasing dosage to achieve a maximal tolerated dose and then titrated to maintain acceptable clinical parameters over the next 48 to 72 hours. Cardiac index increased significantly during the initial titration and at peak effect. Tolerance over the duration of the study was noted in most patients, although further increases in cardiac index could usually be achieved by modest increases in the infusion rate. The peak hemodynamic effect was noted at an average infusion rate of 4.8 micrograms/kg/min. Both stroke volume and stroke work indexes increased during dopexamine hydrochloride infusion in association with decreases in mean arterial, right atrial, mean pulmonary artery and pulmonary capillary wedge pressures, systemic vascular resistance and pulmonary arteriolar resistance. Cardiac output increased by 60% during the infusion and this was out of proportion to the 12% increase in heart rate at peak effect. Most of the increase in cardiac index appeared to be due to the strong vasodilatory profile of the medication producing afterload reduction, with direct inotropic and chronotropic effects contributing to a lesser degree. Drug-related side effects occurred in 4 patients and were easily controlled by down-titration. Dopexamine hydrochloride is an effective and well-tolerated sympathomimetic agent that increases cardiac index while promoting vasodilatation.

Adult↗
PubMed1986

Methods to assess relative reliability of diet records: minimum records for monitoring lipid and caloric intake.

A total of 252 diet records of 18 outpatients attending a lipid clinic were analyzed by a computer-assisted method to determine the minimum number of daily diet records that would be reliable for monitoring dietary adherence. Each subject recorded food intake in special diaries for 14 consecutive days between two clinic visits. All possible randomly selected combinations of 3, 4, 5, 7, 9, and 11 consecutive days of records in the 14-day period were analyzed for calories and lipids. Sets of records were said to be within a 95% confidence interval when the information yielded on any parameter differed by 5% or less from the mean values for the entire 14 days' records. All sets of records for 7, 9, and 11 days were in the 95% confidence range; therefore, 7 consecutive days of food recording were considered the minimum requirement for a 95% confidence limit. Out of 11 possible combinations of 4 consecutive day-sets of records, all but 3 sets were within 95% confidence limits. Consequently, 4 consecutive days of records were deemed acceptable as a reasonable compromise for minimal, reliable monitoring of diet compliance in outpatients for the nutrients studied.

Adult↗
PubMed1985

Female gender is a major determinant of changing subsite distribution of colorectal cancer with age.

Distribution by subsite and sector of 948 colorectal cancers diagnosed in Kansas in 1982 was analyzed in respect to sex and age in a population-based study. Regression analysis of percentage versus age showed decreasing left, increasing right, and unchanged transverse colon occurrence of cancer for both sexes. However, this was statistically significant only for women; left, -0.7066% per year (P = 0.0088) and right +0.6023% per year (P = 0.0012). Regression for seven subsites showed significant changes only for women; with rectosigmoid and sigmoid decreasing and cecum and ascending colon increasing. Similar results were obtained in analysis of the 5822 cases available in the Kansas cancer registry for the years 1978 to 1982. These findings have important implications for screening and diagnosis of colorectal cancer in the elderly, particularly women, and also provide a useful clue in the investigation of colorectal carcinogenesis.

Adult↗
PubMed1984

The therapeutic effects of a playground apparatus on children with behavioral problems.

The " Moonwalk ," an apparatus consisting of an air-filled trampoline, was evaluated as a reward for children with emotional and behavioral problems. Two age groups of hospitalized children, 23 aged 5 to 12 and 12 aged 13 to 18, were evaluated utilizing (a) a 26-item teacher's rating scale; (b) a 4-item, 5-point scale to assign ratings to the students before and after the Moonwalk activity; and (c) the students' response to a 7-item consumer questionnaire. Teacher observers found the younger age group showed improvement in behavior at school after the Moonwalk was offered as a reward. The Moonwalk , as a reinforcement, offered a simple method to improve emotional or behavioral problems in an institutional setting.

Adolescent↗
PubMed1981

Methapyrilene kinetics and dynamics.

A study was undertaken to characterize the H1 receptor blockade, central nervous system depressant properties, and kinetic parameters of methapyrilene in man. Eight healthy subjects received, in random order at weekly intervals, placebo and methapyrilene 20 mg intravenously and 50 mg and 25 mg orally. Methapyrilene exhibited a moderate antihistaminic effect as measured by the reduction of histamine-provoked skin wheals. Sedation and drowsiness were detected only at the first sampling time (0.75 hr) after intravenous doses. The terminal plasma half-life ranged from 1.1 to 2.1 hr, apparent volume of distribution from 2.14 to 6.61 1/kg, and plasma clearance from 0.013 to 0.048 1/min/kg. Systemic bioavailability was low and showed large interindividual differences, ranging from 4% to 46%. Recovery of unchanged drug from the 24-hr urine was under 2% of the doses.

Adult↗
PubMed1978

Uric acid excretion in normal children.

Standard values were established for urinary excretion and clearance of uric acid in 95 normal, nonhospitalized children. We found that urinary uric acid excretion and serum uric values increase throughout childhood; that in early childhood, fractional excretion and clearance of uric acid are higher than adult norms; and that despite an increasing filtered load of uric acid, there is a progressive decrease in fractional excretion and clearance of uric acid with advancing age. Some tubular maturational change, either decreasing secretion or increasing reabsorption, must account for the progressive decline in fractional excretion and clearance of uric acid.

Adolescent↗