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Biomedical subjects

M A Ghoneim

Publications and source records attributed to M A Ghoneim.

At least 163 records · Page 9Linked to original sources
PubMed1987

Fine-needle aspiration biopsy: a reproducibility study and a correlation with the tru-cut biopsy in the evaluation of renal allotransplants.

Forty patients receiving a living related donor kidney transplant in the last 12 months were subjected to evaluation by Fine Needle Aspiration Biopsies (FNABs) and Tru-cut biopsies. The reproducibility of the transplant aspiration cytology was tested by comparing 90 double FNABs (FNAB1 and FNAB2). Furthermore, the accuracy of FNABs was assessed by comparison with 30 kidney transplant Tru-cut biopsies obtained simultaneously. Statistical analysis showed no significant difference (P greater than 0.1) between FNAB1 and FNAB2 and both correlated positively with the Tru-cut biopsies. All the 25 acute rejection episodes documented by Tru-cut biopsies were positive in the simultaneously obtained FNABs. FNABs failed to diagnose histologically documented chronic rejection, humoral rejection, and a case of disseminated intravascular coagulation. In one case with deteriorating graft function, Tru-cut biopsy showed normal histology, yet transplant aspiration cytology showed cyclosporin nephrotoxicity. Sensitivity of transplant aspiration cytology was found to be 90.9% and specificity was 100%. We have concluded that FNAB when performed frequently, especially if double aspirates are obtained, is safe, sensitive and highly specific for diagnosis of renal transplant rejection. Humoral and chronic rejections are major limitations.

Biopsy, Needle↗
PubMed1986

Rigid ureteroscopy for the treatment of ureteric calculi: experience in 120 cases.

Over a 1-year period, rigid ureteroscopy has been used to retrieve ureteric calculi in 120 patients. The technical details, causes of failure and the complications are described. An initial success rate of 78% was obtained. It was concluded that ureteroscopy should replace blind procedures for the extraction of ureteric stones.

Adult↗
PubMed1985

Randomized trial of cystectomy with or without preoperative radiotherapy for carcinoma of the bilharzial bladder.

A prospective randomized clinical trial was done for 92 patients with carcinoma of the bilharzial bladder who underwent radical cystectomy alone or with 2,000 rad preoperative radiation. The postoperative mortality and morbidity were similar in both groups. Patients were followed for a minimum of 60 months. Over-all, there was a marginal, statistically insignificant improvement in survival among patients receiving preoperative radiotherapy. Nevertheless, 2 subpopulations demonstrated significant improvement in survival following preoperative radiation, that is patients with high stage (P3 and P4) and high grade tumors.

Carcinoma, Squamous Cell↗
PubMed1985

Cystectomy for carcinoma of the bilharzial bladder. 126 patients 10 years later.

Our experience with 126 cases of bilharzial bladder cancer treated by radical cystectomy and followed up for at least 10 years is outlined. The operative mortality rate was 13.5%. The 5- and 10-year survival rates were 32.6 and 23% respectively. The difference between the two figures can be attributed to mortality from natural ageing rather than recurrence of cancer. Analysis of survival figures revealed that the tumour grade was the most important prognostic factor. Most treatment failures were due to local recurrence which developed soon after treatment.

Adult↗
PubMed1983

Intravesical administration of misonidazole in bladder carcinoma.

Using 11C labelled material, the diffusion of the hypoxic cell sensitizer misonidazole was tested in 19 patients with carcinoma of the bladder following its intravesical administration. Increasing concentration gradients were tested. Evidence was provided that a 20 ml solution containing 200 mmol/l of misonidazole is followed by high concentrations of the drug in the superficial as well as in deep parts of the tumour. The corresponding serum concentration was extremely low. It was concluded that this route of administration provides high local concentrations of the drug that may result in a significant therapeutic enhancement if utilized as an adjuvant to external irradiation.

Humans↗
PubMed1981

The impact of schistosomiasis on the pathology of bladder carcinoma.

In a series of 1095 Egyptian patients with carcinoma of the bladder treated by radical cystectomy, 902 cases (82.4%) contained schistosome eggs in the specimens, and 193 (17.6%) were egg-negative. The different tumor parameters were compared in these subgroups to explore any differences that could be related to schistosomal infestation. In egg-positive cases, the tumor developed at a younger age (46.7 years) than in egg-negative cases (53.2 years). Squamous cell carcinoma, commonly of low grade, predominated in the egg-positive group. No difference was observed in the frequency of tumor stages or lymph node metastases between the two subgroups. The limited tendency to distant spread in schistosomal bladder cancer, despite its advanced local stage, is accounted for by the high frequency of low grade tumors rather than the limiting effect of local schistosomal tissue reactions.

Adenocarcinoma↗
PubMed1981

Evolution of the rectal bladder as a method for urinary diversion.

A critical analysis of previous reports reveals 2 main drawbacks of the rectal bladder: 1) recurrent pyelonephritis with subsequent loss of renal function (30 per cent) and 2) nocturnal urinary leakage (40 per cent). In a randomized prospective study the role of a submucosal tunnel for prevention of reflux was evaluated. We demonstrated objectively that this technique could provide a patent unidirectional flow of urine in the majority of cases (82.5 per cent). Urodynamic measurements, including flowmetry, rectal pressure and anal electromyography activities, indicated that the driving force for voiding is the voluntary increase of the intra-abdominal pressure rather than the intrinsic contractions of the smooth muscles of the rectum. Accordingly, attempts at control of nocturnal urinary leakage were directed towards increasing the resistance offered by the pelvic floor. The efficiency of imipramine hydrochloride to achieve this goal was tested against a placebo in a clinical trial performed in a prospective randomized fashion. This treatment was effective in the control of enuresis in a significant number of patients (75 per cent). We conclude that the rectal bladder with a terminal colostomy is a highly recommended method for permanent urinary diversion when these 2 modifications are used.

Clinical Trials as Topic↗
PubMed1981

The effect of exogenous prostaglandins F2 alpha and E2 and indomethacin on micturition.

The influence of exogeneous infusion of prostaglandins (PGs) of the F2 alpha and E2 series and of indomethacin on micturition cycles was investigated in 30 anaesthetised female dogs. In 30 other animals, urethrovesical disconnection was performed to study the action of PGs and of indomethacin without the muscle continuity factors. In the intact animal model during vesical distension, PGE2 produced a significant urethral pressure drop and a dose-dependent reduction in the threshold micturition volume. PGF2 alpha produced a significant urethral pressure rise. At doses higher than 0.3 micrograms/kg, PGF2 alpha reduced the threshold micturition volume. On the other hand, indomethacin significantly increased the threshold micturition volume and reduced the maximum intravesical pressure. In the disconnected model, PGE2 produced a dose-dependent decrease in the resting urethral pressure and hardly affected the intravesical pressure; PGF2 alpha produced a dose-dependent increase in both urethral and intravesical pressures. Thus it is suggested that endogenous PG release during vesical distension could play a facilitatory role in micturition.

Animals↗
PubMed1980

Results of treatment in carcinoma of the bilharzial bladder.

Radical cystectomy with some form of urinary diversion still remains the most commonly used method to treat patients with carcinoma of the bilharzial bladder. The reported 5-year survival rate following this procedure ranges from 27 to 38 per cent. Research efforts currently are directed to 2 areas. One area is screening the population at high risk by urine cytology for detection of early cases. This procedure may either improve the end results of existing methods of treatment or allow the adoption of techniques of lesser magnitude than radical cystectomy with its attendant relatively high mortality and inevitable physiologic and functional losses. Studies also are in progress in an attempt to enhance the therapeutic yield of the current treatment modalities. Preoperative radiation and cystectomy are examples. The possibility of promotion of the radioresponsiveness and improvement of the therapeutic response also is being explored by administration of chemical hypoxic cell sensitizers and/or the application of more optimized fractionation techniques.

Humans↗
PubMed1979

Cystectomy for carcinoma of the bilharzial bladder: 138 cases 5 years later.

Our experience is outlined with 138 cases of bilharzial bladder cancer treated by radical cystectomy and followed for 5 years. The operative mortality was 13.7%. The 5-year survival rate was 32.6%. Analysis of survival figures revealed that the tumour grade was the most important prognostic factor. Most treatment failures were due to local recurrence which developed early after treatment. It was concluded that improvement in survival might be obtained by some form of pre-operative irradiation augmented by the use of a hypoxic cell sensitiser.

Adult↗
PubMed1977

A comparative study of two preoperative radiation regimens with cystectomy for bladder cancer.

This report surveys the results of two programs of preoperative irradiation with radical cystectomy for bladder cancer in 205 patients. Irradiating the true pelvis to 4000 rads in 4 weeks with radical cystectomy after 6 weeks was implemented in 119 patients (Group 1) from 1959 to 1965; 2000 rads given in 1 week to the true pelvis and radical cystectomy within the following week was implemented in 86 patients (Group 2) from 1966 to 1970. Determinate survival without evidence of recurrence at 5 years was 43% in Group 1 and 42% in Group 2. Mortality with recurrence of bladder cancer in 5 or more years was 44% in group 1 and 42% in group 2. Pelvic complications occurred in 13% of group 1 and 9% of group 2.

Adenocarcinoma↗
PubMed1976

Radical cystectomy for carcinoma of bilharzial bladder. Technique and results.

One hundred and sixty-two patients with carcinoma of the bilharzial bladder were treated by radical cystectomy. The postoperative mortality was 12.9 per cent and the five-year survival rate was 38.9 per cent. Correlations of the survival figures relative to the various pathologic features of the tumor revealed that squamous and transitional tumors have essentially the same prognosis, and that the most important prognostic index was the tumor grade. In most cases treatment failures were due to local recurrences which developed within one year after operation.

Adenocarcinoma↗
PubMed1976

The influence of vesical distension on the urethral resistance to flow: a possible role for prostaglandins?

The possible role of prostaglandins in the mediation and/or modulation of the urethral response to vesical distension was investigated in female dogs. Three criteria for the possible involvement of these mediators have been investigated. Indomethacin could block the reduction of urethral resistance observed during vesical distension. Intra-arterial infusion of exogenous prostaglandin E2 resulted in a dose-dependent reduction in the urethral resistance to flow. Moreover, a significant release of prostaglandin E2 in the venous blood during the course of vesical distension could be demonstrated. The functional significance, mechanisms of release and mode of action of these highly active lipids are discussed.

Animals↗
PubMed1976

Study on the efficiency of electric stimulation of the pelvic floor.

The continuous electric stimulation of the anal sphincter leads to the onset of a very quick fatigue of the muscle, with a progressive decrease of the amplitude of contraction after 15 min of stimulation. Under the same experimental conditions intermittent stimulation leads to a sustained contraction amplitude. Ts and Tr combinations that can give efficiency rates of contraction above 80 per cent were defined. The results of this study could be applied when intermittent electric stimulation of the pelvic floor is indicated for the treatment of anal or urinary incontinence.

Anal Canal↗