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Biomedical subjects

K Moghissi

Publications and source records attributed to K Moghissi.

At least 55 records · Page 3Linked to original sources
PubMed1989

Chemotherapy-induced premature ovarian failure: mechanisms and prevention.

Significant advances have been made in the previously unexplored areas of the mechanisms involved in cyclophosphamide (CTX)-induced ovarian toxicity and the protective effects of luteinizing hormone-releasing hormone (LHRH agonists. The structure and function of granulosa cells and oocytes are affected by the chemotherapeutic agent, CTX. Results of experiments in female rats indicate that LHRH agonists may protect the ovaries from the toxic effects of chemotherapy. The protective effect may be related to the inhibition of ovarian mitotic activity during LHRH agonist administration. This inhibition is much more pronounced in female compared to male rats. This may be related to the observed better gonadal protective effects in females compared to males. Further experiments are underway to determine whether similar protective effects occur in female primates.

Animals↗
PubMed1989

Management of proximal oesophageal stricture.

Thirty-two patients with proximal oesophageal stricture who were treated under one surgeon (K.M.) during a 17-year period are reviewed. The cause of the stricture in these cases was widely varied and included: gastro-oesophageal reflux (Barrett-type oesophagus), radiotherapy and post-surgical anastomosis following oesophageal reconstruction. Seventeen patients were treated by repeated endoscopic dilatation. Of the remaining 15, 3 patients only (1 with suspected malignancy and 2 with occult cancer) needed resection and reconstruction of the oesophagus. Twelve patients underwent simple conservative operations. There was no hospital or treatment related mortality in this series. We concluded that the majority of such strictures respond to repeated endoscopic dilatation or conservative surgical operation. It is mandatory to exclude malignancy in obstructive lesions of the proximal oesophagus and it is important to establish the aetiology of the lesion in order to undertake the most appropriate treatment.

Dilatation↗
PubMed1989

Local excision of pulmonary nodular (coin) lesion with noncontact yttrium-aluminum-garnet laser.

Local excision of pulmonary nodular lesions with the noncontact mode of the neodymium: yttrium-aluminum-garnet laser was done in 14 patients. This was achieved through a conventional limited thoracotomy and then by evaporation/fulguration of 0.5 to 1 cm of the healthy parenchyma surrounding the lesion, which produced a bloodless incision. In 10 patients the lesion was a primary (N = 7) or secondary (N = 3) malignant tumor. The remaining four had a benign nodule. Preoperative radiology has demonstrated a solitary nodule in all 14 patients, but at operation in four patients (three with benign and one with malignant disease) there were two nodules. In each of these four patients the smaller nodule was evaporated entirely, without excision of normal pulmonary tissue. There were no hospital deaths or postoperative complications. One patient died 8 months postoperatively (carcinomatosis); the other 13 remain alive and well between 2 and 25 months after treatment. We believe that local excision of nodular pulmonary lesions with the laser should be considered whenever possible, particularly in high-risk patients, those with limited respiratory function, and in the elderly.

Aged↗
PubMed1988

Administration of nasal nafarelin as compared with oral danazol for endometriosis. A multicenter double-blind comparative clinical trial.

Treatment with nafarelin, a gonadotropin-releasing hormone agonist, reversibly inhibits ovarian function and induces hypoestrogenemia. To determine the efficacy of such hormonal manipulation in the treatment of endometriosis, we randomly assigned 213 patients with laparoscopically confirmed endometriosis to receive, for six months, either nafarelin by nasal spray (400 or 800 micrograms per day) or oral danazol (800 mg per day). Placebo nasal spray and placebo tablets were used to double blind the study. Pretreatment and post-treatment laparoscopies were compared by means of the American Fertility Society's scoring system. More than 80 percent of the patients in each treatment group had a reduction in the extent of disease as assessed by laparoscopy. The mean laparoscopic scores decreased from 21.9 to 12.6 with 800 micrograms of nafarelin, from 20.4 to 11.7 with 400 micrograms of nafarelin, and from 18.4 to 10.5 with danazol (P = 0.0001 within each group; there were no statistically significant differences between the groups). The percentage of women with severely painful symptoms of endometriosis decreased from about 40 percent to 5 to 10 percent, whereas the percentage with no or minimal discomfort rose from 25 to 70 percent. Of the 149 patients who tried to become pregnant, 58 (39 percent) succeeded after the completion of treatment; similar rates of pregnancy applied to the three treatment groups. Danazol use decreased high-density lipoprotein levels and increased low-density lipoprotein levels. These changes were not observed in nafarelin users, but a higher percentage of them reported hot flashes and decreased libido. We conclude that nafarelin is an effective agent for treating endometriosis and has few side effects other than hypoestrogenism.

Administration, Intranasal↗
PubMed1988

Experience in non-contact Nd YAG laser in pulmonary surgery. A pilot study.

This paper presents our experience and the results of a pilot study in non-contact Nd YAG laser in pulmonary surgery. During an 18-month period laser was used in 43 patients undergoing pulmonary surgery. All patients had a thoracotomy using a conventional surgical technique but the laser was employed for the pulmonary operation. The laser equipment consisted of Pilkington Fibrelase 100, delivering 10-100 watts energy in pulses of 1-9 s. The laser energy was applied using our sterile applicator and as a non-contact mode. Seven patients (group 1) had "coin" pulmonary lesions excised solely by laser evaporation and fulguration of 0.5-1 cm around the margin of the lesion. In 24 patients (group 2) laser was used in conjunction with conventional surgery in order to excise the residual disease and to provide better clearance with less loss of healthy parenchyma. In 17 patients (group 3) the laser was used to dispose of lymph nodes which were inaccessible for resection by conventional surgical methods. In 8 patients (group 4) laser was used for the purpose of haemostasis. Some patients in groups 2, 3 and 4 fell into categories other than that of their defined groups. There was no mortality or morbidity associated with the laser in these patients. This experience indicates the potential usefulness of laser in lung surgery and its particular value in pulmonary "coin" lesions and in association with conventional surgery in order to achieve conservative lung resection.

Adult↗
PubMed1988

Instrumental perforations of the oesophagus and their management.

The records of 39 patients who had developed a perforation of the oesophagus after instrumentation were reviewed. Ten (group A) had cervical and 29 (group B) thoracic oesophageal perforation. Twenty three perforations occurred during dilatation of an oesophageal stricture, 10 during oesophagoscopic removal of a foreign body, and six during diagnostic oesophagoscopy. Of the 21 patients treated within 36 hours (early treatment group), four (19%) died; of the 18 treated more than 36 hours after the perforation (late treatment group), nine (50%) died. None of the 10 patients in group A had strictures and only two presented late. After drainage of the neck and mediastinum the outcome was successful in all patients. Thirteen of the 29 in group B were treated early and four of these died; nine of the 16 treated late died, the total mortality for thoracic perforation being 48%. An oesophageal stricture was present in 23 patients. Twelve of these underwent various forms of conservative surgery and there were 10 deaths. This contrasts with the 11 who received radical treatment with resection and reconstruction, only two of whom died. The six patients with no pre-existing stricture were treated with conservative forms of surgery, with one death.

Adolescent↗
PubMed1988

Instrumental perforations of the oesophagus.

Instrumental perforation of the oesophagus is a serious and potentially fatal complication of oesophagoscopic procedures. Thoracic perforations are more serious than cervical ones and those above an oesophageal stricture carry the highest mortality. Every effort should be made to diagnose early and to institute prompt and appropriate treatment.

England↗
PubMed1987

Copper-containing IUDs are not associated with an increase of malondialdehyde levels in cervical mucus.

The malondialdehyde (MDA) content of cervical mucus from 23 healthy adult females was measured using an ion-pairing HPLC method capable of detecting 10 pmol MDA. Ten of the women were wearing copper IUDs, four were wearing plastic IUDs, and nine controls were not wearing an IUD. Cervical mucus was sampled during the follicular, periovulatory, luteal, and menstrual phases. The study was designed to determine if there is a relationship between MDA formation and the use of a copper IUD. A total of 79 samples were analyzed. Only 16 of the samples had sufficient MDA for reliable quantitation with the level ranging from 0.1 nmol/g to 2.32 nmol/g. In 19 of the samples, trace levels (less than 0.06 nmol/g) were detected but could not be reliably quantitated. In the remaining 44 samples, no MDA was detectable. There was no correlation between the presence of copper- or non-copper-containing IUDs and the level of MDA. These results are contrary to a previously published report that used a less specific method for MDA analysis.

Adult↗
PubMed1979

Conservative surgery in reflux stricture of the oesophagus associated with hiatal hernia.

During a 7-year period, 130 patients with oesophageal stricture resulting from long-standing reflux oesophagitis and hiatal hernia were referred for surgery. Eighty-seven of these patients underwent conservative surgery consisting of intraoperative transgastric retrograde dilatation combined with one of two types of anti-reflux operation: in 34 patients (group 1) an Allison-type operation for hiatal hernia was undertaken, and in the remaining 53 patients (group 2), a Nissen-type fundoplication was carried out. In 22 patients in this latter group the oesophagogastric junction could not be brought down into the abdomen in spite of extensive oesophageal mobilization and the fundoplication was finally placed above the diaphragm. From the successful results in both groups (particularly in group 2), it is concluded that conservative surgery should be considered in cases of hiatal hernia with a reflux stricture that yields to intraoperative dilatation.

Adolescent↗
PubMed1979

Levamisole and surgery in bronchial carcinoma patients: increase in deaths from cardiorespiratory failure.

Life table analysis of early entry to this randomised blind trial of 318 patients has shown a significantly poorer survival for resected lung cancer patients treated with levamisole for three days before operation and three days a fortnight thereafter than for placebo-treated controls. This excess was largely due to deaths that had been attributed to operation or other causes (non-cancer deaths), most occurring in the six weeks after operation. In the 99 resected patients treated with levamisole there was a 15% excess of deaths in this category, compared with the placebo-treated controls. Extensive analysis excluded maldistribution of patients between the groups as a cause of this difference. Many more died in respiratory distress, mostly without clear cause, in the levamisole group. Antibody (lgG) reacting with myocardial sarcolemma or sarcoplasm was found in the only serum samples available for testing which were drawn from patients during the syndrome. The findings are in keeping with a primary effect on the heart, possibly involving an autoimmune mechanism. The effect has not been noted in other trials.

Adenocarcinoma↗