Biomedical subjects
Publications and source records attributed to M Amin.
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Fifteen patients underwent subcapsular orchiectomy with placement of an intracapsular testicular prosthesis for hormonal treatment of symptomatic Stage D carcinoma of the prostate. Serum testosterone decreased to castration levels, and the intracapsular prosthesis was often indistinguishable from a normal testicle postoperatively. This new technique of castration may be considered an alternative in those patients reluctant to undergo other forms of orchiectomy.
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This retrospective review is the first to compare recurrence rates of calculi of the bladder following each of the three common methods. In 39 patients with bladder calculi and indwelling catheters, the recurrence rate of calculi of the bladder within two years was significantly greater following litholapaxy (44.1 per cent) or EHL (50.0 per cent) than vesicolithotomy (7.4 per cent). The average stone-free interval was shorter after litholapaxy (18.4 months) or EHL (13.8 months) than vesicolithotomy (70.8 months).
Thirty patients with colovesical fistula due to diverticulitis were encountered in the past ten years. Six patients did not receive any of the standard operative therapies. Four of these patients were observed for three to 14 years with nonoperative management, with little inconvenience and without significant complications. Five of the 24 patients in the surgical group died in the postoperative period. Nonoperative therapy seems to be a viable option in selected patients.
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We report on a patient with systemic blastomycosis who presented with acute epididymitis that was followed by the appearance of typical skin and pulmonary lesions. An excellent clinical response was obtained with ketoconazole, a new oral antifungal agent. Only 2 cases of systemic blastomycosis that were treated with ketoconazole have been reported and neither patient had genitourinary involvement. The diagnosis and treatment of systemic blastomycosis with genitourinary involvement, and ketoconazole as the treatment of fungal infections are discussed.
In a retrospective review of 100 consecutive patients (50 adults and 50 children) with acute appendicitis we correlated abnormal urinalysis (positive occult blood and more than 4 red or white blood cells per high power field) with the operative findings. Abnormal results on urinalysis were noted in 18 adults and 12 children. All urine specimens were collected by the clean-catch method. Abnormal findings were found more frequently in female patients. A majority of patients (53 per cent) with abnormal results on urinalysis had a ruptured or inflamed appendix in proximity to the urinary tract.
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Recent interest in transperitoneal live donor nephrectomy prompted us to review our experience with 104 live donor nephrectomies performed through a standard flank extraperitoneal approach. There were no deaths and 14.4 per cent of the patients had minor complications that were managed easily. Factors influencing morbidity in the voluntary donor are analyzed.
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Open pelvic fracture is a devastating injury with a reported 50% mortality rate from massive bleeding and pelvic sepsis. Utilizing a graded approach to management of hemorrhage that included wound packing, anti-shock trousers, angiographic embolization, and hemipelvectomy, we controlled bleeding in all but one of the 35 patients in this series. Patients lost an average of 15 units of blood. The overall survival rate was 94.5% in this series, with one death each from hemorrhage and head injury. Prevention of invasive infection by a diverting colostomy in patients with buttock wounds or perineal wounds was stressed, while anterior soft-tissue wound were managed selectively. Debridement and frequent dressing changes under anesthesia were necessary to prevent and/or treat soft-tissue infection. Associated injuries occur commonly with genitourinary and peripheral nerve trauma and account for the majority of the long-term morbidity.