Terminal loop cutaneous ureterostomy in renal transplantation.
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Humans↗
Biomedical subjects
M Amin
Publications and source records attributed to M Amin.
Pattern of gross displacement of the vocal fold in adduction and abduction movements.
The pattern of gross displacement of the vocal fold during adduction and abduction was studied in 4 adult fresh human larynges (2 males and 2 females). Markers were placed on specific sites along the edge of the vocal fold. Preliminary observations showed upward and lateral movement of the free edge during abduction. The vocal fold as a whole glides into and fills the cavity of the laryngeal ventricle. To quantify this observation 14 larynges (8 males and 6 females) were studied, using a technique designed to measure vertical and horizontal displacement of the vocal fold. An average of a 1.34 mm elevation and 4.43 mm lateral excursion were observed at midvocal fold level. A model for studying the pattern of vocal fold abduction is suggested and discussed.
Adult↗
Comparison of the cost-effectiveness of various therapies for common prostatic disorders.
Diseases of the prostate currently represent a major health problem worldwide. As the age of the male population increases in the future, so will the number of patients suffering from these disorders and the cost for treatment increase. Currently, benign prostatic hyperplasia (BPH) and prostate cancer are common in men over 50 years of age. In men after puberty, prostatic infections (prostatitis) are common. Each condition carries with it controversy regarding the most cost-effective treatment. Treatment for these disorders can include surgical intervention, drug therapy, or no treatment at all. In the United States, surgery is the usual treatment of BPH in men over 65 years of age, but most patients with BPH are asymptomatic and require no intervention. Aside from acute urinary retention or backpressure that compromises renal function, the indications to perform surgery are questionable. While some alpha-adrenergic antagonists are used to temporarily relieve symptoms, many patients with BPH will eventually require surgery. Transurethral resection of the prostate is the surgical treatment of choice in selected patients with BPH, accounting for over 90% of surgery performed in this area. The risk-to-benefit ratio for this procedure is favourable and cost-saving steps can be taken by the physician. Open prostatectomy, both suprapubic and retropubic, is performed to treat large prostates. However, both hospital stay and overall morbidity is higher for open prostatectomy than for transurethral prostatic resection. Radical prostatectomy and radiotherapy are commonly performed to treat patients with cancer of the prostate. For patients with the early stages of the disease, administering no treatment is also acceptable. Each therapeutic method has its advocates, and overall survival rates are similar for all treatments. Radiotherapy, however, is less expensive. We review the magnitude of these diseases, therapies available and relevant cost-effectiveness studies. When this sort of scientific information is not taken into account, the physician's decision of which therapy to choose is sometimes blinded by the prejudices and fears of the patient.
Catheterization↗
Cocaine-induced myocardial infarction. A growing threat to men in their 30s.
A clear association has been established between cocaine use and acute myocardial infarction. Because of the continuing rise in cocaine use in the United States, many more young patients have or will have this disorder. Such patients are usually managed conservatively with calcium channel blockade and have an excellent in-hospital prognosis. If chest pain recurs or stress testing reveals evidence of ischemia, cardiac catheterization should be done. If cocaine use is discontinued, the long-term prognosis of a typical patient with cocaine-induced acute myocardial infarction is excellent in the absence of other chronic illnesses.
Adult↗
Prevalence of cryptosporidiosis in dogs and human beings in San Bernardino County, California.
Fecal specimens from 200 stray dogs impounded at the San Bernardino City and County animal shelters were screened for Cryptosporidium sp oocysts, using the auramine-rhodamine fluorescent staining procedure. The University of California, Los Angeles acid-fast stain was used for confirmation. Only 4 (2%) dogs were passing cryptosporidial oocysts. Likewise, stool specimens from 664 people were submitted to the San Bernardino County Department of Public Health Laboratory for routine parasitologic examination and were screened for Cryptosporidium sp. Cryptosporidial oocysts were detected in 20 human fecal specimens (3.01%). On the basis of these findings, it appears that the human and canine populations of San Bernardino County are at low risk for development of cryptosporidiosis at this time.
Age Factors↗
Variable gastrointestinal and urologic cancers in a Lynch syndrome II kindred.
There are no premonitory physical signs or biomarkers which can identify the genotypic status in Lynch syndrome II. Diagnosis is therefore dependent on the pedigree, with attention to cancer of all anatomic sites, inclusive of those cardinal features of its natural history. The tumor spectrum in Lynch syndrome II has continued to expand commensurately with increasing interest in this disorder. We report a family showing the constant cancer features of this syndrome but, in addition, occurrences of carcinoma of the bile duct, urologic system, and extremely early-onset carcinoma of the pancreas, in patients in the direct genetic lineage who were considered to be candidates for having inherited the deleterious genotype. Diagnosis of Lynch syndrome II is crucial in targeting its surveillance and management.
Colonic Neoplasms↗
Pacemaker infection with Mycobacterium avium complex.
A 21-year-old. HIV negative, malnourished, homeless woman with congenital heart block had a pacemaker implanted at 7 years of age and multiple procedures thereafter. The most recent of these procedures was replacement of a pulse generator in the right pectoral region. Four months later she had fever, pain, and swelling over the implant site resulting from infection with mixed flora and Mycobacterium avium complex. The pacemaker system was removed by thoracotomy via a median sternotomy and a new DDD pacemaker simultaneously implanted. She was treated with systemic antibiotics--isoniazid, rifampin, ethambutol--for 2 weeks. Six months later she was healthy, pacing well, and apparently free of infection, off all medications.
Adult↗
Current concepts in the treatment of genitourinary tract disorders in the older individual.
Genitourinary problems, including neurogenic dysfunction, impotence, prostatism, urinary tract infections, and prostate cancer, are common in the elderly, and most of the symptoms can be alleviated through pharmacological management. Patients with neurogenic dysfunction who present with symptoms such as incontinence and urinary retention can be appropriately managed with bladder and sphincter relaxants or stimulants. Anticholinergic agents in the form of oxybutynin, flavoxate, and propantheline are effective bladder relaxants, and phenoxybenzamine, prazosin, and terazosin are commonly used as sphincter relaxants. Bethanechol chloride is the agent most commonly used to stimulate bladder contraction, but physicians should be careful when prescribing it for elderly patients with cardiovascular problems. Organic and psychogenic causes of impotence usually overlap, and oral agents have limited use in the treatment process. The use of yohimbine has increased recently, but its value and rate of success remains questionable. Testosterone is being used widely to treat impotence, but it is only helpful to patients with hypogonadism and should be used with discretion in the elderly, who have a high incidence of prostate cancer. Vasoactive intracavernous pharmacotherapy, on the other hand, is a recently discovered alternative to testosterone with promising results. Although the treatment of choice for benign prostatic hypertrophy is surgery, there have been important pharmacological advances in treating this disorder. alpha-Adrenergic antagonists and anti-androgenic agents have been found to relieve the symptoms of prostatic enlargement. The use of chemotherapeutic and antibiotic agents to treat and suppress acute and chronic urinary tract infections is reviewed; these are second only to pulmonary infections as the most frequent cause of febrile episodes in patients over the age of 65. Lower urinary tract infections can be treated with almost any antibacterial agent. Upper urinary tract infections require full genitourinary evaluation and appropriate antibiotics should be used according to the urine culture sensitivity studies. With the advent of new hormonal agents, more choices are now available for the management of prostate cancer, which is the second most common malignancy in men. Diethylstilbestrol (stilboestrol), an oral estrogen, remains a commonly used agent to achieve castrate levels of androgens in advanced prostatic carcinoma. Agonist analogues, such as goserelin and leuprorelin, of gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH); or gonadorelin] achieve the same results as diethylstilbestrol but without the cardiovascular side effects. Antiandrogens are also being used in combination with GnRH agonists to produce complete androgen blockage, with mixed results.
Aged↗
Thigh bleeding time as a valid indicator of hemostatic competency during surgical treatment of patients with advanced renal disease.
We compared the usefulness of the modified Ivy bleeding time performed in the forearm (arm bleeding time) with that performed in the thigh (thigh bleeding time) as an indicator of hemostatic competence during surgical treatment in 16 patients with chronic renal failure. In 22 normal adults, the arm bleeding time (mean plus or minus standard deviation, 6.6 +/- 1.4 minutes) was significantly longer than the value in the thigh (mean plus or minus standard deviation, 4.1 +/- 1.3 minutes) (p less than 0.001), and there was no correlation between arm and thigh bleeding time. Preoperatively, the arm bleeding time in patients with renal disease was markedly prolonged (greater than 20 minutes) in 15 patients and slightly prolonged in one patient. There was no abnormal perioperative bleeding in 13 patients whose preoperative thigh bleeding time was seven minutes or less. Prolonged and excessive perioperative bleeding was observed in three patients whose thigh bleeding time was 8.0, 9.5 and 26.5 minutes. These findings suggest that thigh bleeding time is a better indicator of competence of primary hemostasis during the operation than the arm bleeding time in patients with advanced renal failure.
Adult↗
Preliminary vascular control for renal trauma.
Preliminary control of the renal vascular pedicle prior to opening Gerota's fascia is advocated as the standard approach for decreasing the rate of nephrectomy from trauma. This method, however, has not been studied widely. Previous reports failed to grade the severity of the renal injury and involved small patient series and historic control for comparison of nephrectomy rates. We studied 297 patients with renal trauma during a ten year period. Sixty-three of 75 patients with penetrating injuries and 12 of 222 patients with blunt injuries underwent renal exploration. We obtained vascular control prior to opening Gerota's fascia in 32 patients; it was obtained in 43 patients after opening Gerota's fascia. The nephrectomy rate depended on the degree of injury rather than on the type of renal vascular control obtained. Obtaining vascular control after opening Gerota's fascia did not increase the nephrectomy rate and shortened operative time by an average of 58 minutes. We recommend vascular control after opening Gerota's fascia when there is a large hematoma crossing the midline, a rapidly expanding renal hematoma, if the patient is unstable, or if Gerota's fascia has already been opened by the injury.
Accidents, Traffic↗
Acute myocardial infarction and chest pain syndromes after cocaine use.
Seventy patients hospitalized with chest pain after cocaine use were retrospectively evaluated to define the risk and clinical course of acute myocardial infarction (AMI). AMI developed in 22 patients (31%) and transient myocardial ischemia was seen in an additional 9 patients (13%). Coronary risk factors did not distinguish those who developed AMI from those who did not. The presenting electrocardiogram was abnormal in 20 of 22 patients who evolved AMI and in 19 of 48 of those who did not. Creatine kinase levels were elevated in 75% of the patients, including 65% of those who did not develop AMI, but creatine kinase-MB elevations were only observed in the AMI group. The route of cocaine administration did not predict AMI and there was no predilection for a particular coronary vascular bed. The length of time between drug use and onset of AMI pain was often quite prolonged (median interval, 18 vs 1 hour in the non-AMI group). Eight of the patients with AMI underwent cardiac catheterization and 4 had significant coronary narrowing.
Adult↗
Infundibulopelvic dysgenesis: a spectrum of obstructive renal disease.
Infundibulopelvic dysgenesis is an obstructive process of the pyelocalyceal system that is responsible for a spectrum of congenital renal disorders. The site and degree of narrowing in the infundibulopelvic system produce the various congenital anomalies like hydrocalycosis, calyceal diverticula, ureteropelvic junction stenosis, and multicystic kidney. A classification with illustrative cases is presented showing a common pathogenesis of these congenital obstructive anomalies.
Adult↗
Treatment of radiation or cyclophosphamide induced hemorrhagic cystitis using conjugated estrogen.
Five patients with severe hemorrhagic cystitis induced by radiation and/or cyclophosphamide were systematically treated with conjugated estrogen. Two patients received conjugated estrogen twice each day (1 mg. per kg.) intravenously, followed on day 3 and thereafter by 5 mg. per day orally. Hematuria decreased markedly 6 to 8 hours after the initial dose and urine color became light yellow within 1 to 3 days. The other 3 patients received 5 mg. conjugated estrogen per day orally and urine color became clear within 4 to 7 days. Hematuria did not recur during 12 to 22 months in 4 patients who received daily conjugated estrogen (1.25 mg.). However, transient episodes of mild hematuria persisted in 1 patient during the 3-month followup despite a higher dose of conjugated estrogen (10 mg. per day). Complications, including thromboembolism and other side effects associated with conjugated estrogen, were not observed in these patients. We postulate that conjugated estrogen controls hematuria in hemorrhagic cystitis by decreasing the fragility of the mucosal microvasculature of the bladder.
Adult↗
Negative growth regulation in a glioblastoma tumor cell line that conditionally expresses human wild-type p53.
To investigate the effect that human wild-type p53 (wt-p53) expression has on cell proliferation we constructed a recombinant plasmid, pM47, in which wt-p53 cDNA is under transcriptional control of the hormone-inducible mouse mammary tumor virus promoter linked to the dominant biochemical selection marker gene Eco gpt. The pM47 plasmid was introduced into T98G cells derived from a human glioblastoma multiforme tumor, and a stable clonal cell line, GM47.23, was derived that conditionally expressed wt-p53 following exposure to dexamethasone. We show that induction of wt-p53 expression in exponentially growing cells inhibits cell cycle progression and that the inhibitory effect is reversible upon removal of the inducer or infection with simian virus 40. Moreover, when growth-arrested cells are stimulated to proliferate, induction of wt-p53 expression inhibits G0/G1 progression into S phase and the cells accumulate with a DNA content equivalent to cells arrested in the G0/G1 phase of the cell cycle. Taken together, these studies suggest that wt-p53 may play a negative role in growth regulation.
Blotting, Northern↗
Experience with interferon in chronic hepatitis B in Egypt.
Forty patients with compensated chronic active hepatitis B and elevated aminotransferases who were HBsAg and HBeAg positive were randomised to a treatment group receiving recombinant interferon alpha-2b (rIFN alpha-2b) or no treatment as a control group. The treated patients were divided into 2 groups, group I (n = 12) received IFN in a dose of 5 MU/m2 thrice weekly by subcutaneous injection for 16 weeks, and group II (n = 8) received the same dose daily for the same duration. Patients were followed up for 12 months after therapy ended. Initiation of IFN therapy was associated with an increase in aminotransferases, reaching a peak at 4-6 weeks in most patients, associated with clearance of HBeAg. At end of follow-up, 81% of the treated patients had cleared HBeAg vs 33% of the control group (p less than 0.01). Changes in other HBV markers were more frequent in the treated patients, though insignificantly. The type of response to therapy was significantly related to the duration of illness, being shortest in those who cleared HBsAg. A complete response to therapy with loss of HBsAg was associated with marked reduction in biochemical and histological activity. A partial response with clearance of HBeAg was associated with moderate improvement in biochemical parameters and ongoing activity in liver histology; whereas persistence of HBeAg was associated with elevated aminotransferases and histological deterioration in most cases. The rise in aminotransferases during seroconversion was associated with hepatic decompensation and death on 3 occasions: one during spontaneous seroconversion, and the other 2 during IFN therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Treatment of obstructive sleep apnea. A preliminary report comparing nasal CPAP to nasal oxygen in patients with mild OSA.
Nasal CPAP is presently accepted as first-line therapy for obstructive sleep apnea, but a significant minority of patients do not tolerate nasal CPAP. The purpose of this study was to compare the benefits of nasal CPAP, nasal oxygen (O2), and placebo (air) using patients as their own controls. We studied eight men, aged 33 to 72 (mean 57 years), who had mild obstructive sleep apnea. To be eligible for study, patients had to have an apnea plus hypopnea index greater than or equal to 5, plus one or more of the following: blood pressure greater than 150/95 mm Hg, multiple sleep latency test mean score less than or equal to 10 minutes, or significant nocturnal cardiac ectopy. After a baseline study, patients received a month each of nocturnal O2 at 4 LPM and air at 4 LPM, presented in random order. The third month of treatment consisted of nasal CPAP (range 2.5 to 12.5 cm H2O). Patients underwent evaluation at baseline and after each month of treatment. It was concluded that oxygen was more effective in improving oxygenation and hypopneas than is nasal CPAP. However, oxygen did not reduce apneas or improve daytime hypersomnolence as well as nasal CPAP in patients with mild OSA. Oxygen might be considered as an alternate form of treatment for patients who are not hypersomnolent, or as an adjunct to nasal CPAP.
Adult↗
Carcinoma of the prostate simulating primary bladder cancer.
After encountering two patients who were diagnosed as having primary bladder cancer but were ultimately found to have carcinoma of the prostate invading the bladder, a prospective study was undertaken. In five patients with known carcinoma of the prostate invading the bladder, cup biopsies of the bladder lesions were reported as primary bladder cancer in four patients. To prevent this error, immunohistochemical studies are required and discussed in this paper.
Aged↗
Wild type human p53 is antiproliferative in SV40-transformed hamster cells.
The transformation related protein p53 has been implicated in the process of normal cell proliferation and neoplastic transformation. In this study, the influence of wild type human p53 on cell proliferation was examined. Plasmid constructs encoding the wild type human p53 and various mutant p53 cDNAs, driven by the mouse mammary tumor virus (MMTV) promoter linked to the dominant biochemical selection marker gpt, were used in a colony forming assay employing SV40 transformed HR8 hamster cells. Plasmids encoding wild type p53 drastically reduced the number of gpt+ colonies obtained after transfection, whereas the mutant forms of p53 had no effect. Stable clonal hamster cell lines that constitutively express wild type p53 were isolated and found to have altered growth characteristics (i.e. lower saturation densities, increased doubling times). These findings are consistent with the notion that wild type p53 protein could function as a growth suppressor. The potential role of p53 in the normal cell cycle and in the transformation process is discussed.
Blotting, Northern↗