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Biomedical subjects

N F Dabhoiwala

Publications and source records attributed to N F Dabhoiwala.

At least 19 recordsLinked to original sources
PubMed1993

Analysis of biopsy findings and implant quality following ultrasonically-guided 125I implantation for localised prostatic carcinoma.

Transperineal ultrasound-guided 125I implantation was undertaken in 52 patients with localised prostate cancer. After implantation, ultrasound-guided biopsies were taken from the previous malignant areas every 6 months in all patients. The percentage of negative biopsies increased from 22% at 6 months to 50% at 48 months. Implant quality was analysed in 37 patients. The difference between isodose levels encompassing the prostate and the aimed levels of 160 Gy was taken as a measure of implant quality. A good quality implant (< 10% underdosage) was found in 43% of patients, a moderate quality (10-25% underdosage) in 35%, and a poor quality implant (> 25% underdosage) in 22%. A statistically significant correlation was found between the quality of the implant and resulting negative biopsy at the original tumour site. Determination of prostate specific antigen (PSA) was not possible from the beginning of the study but an analysis with biopsy findings, implant quality and prostate volume reduction during follow-up has been performed since 1989. A significant correlation was observed between implant quality and serum PSA, and also between volume reduction and serum PSA.

Aged↗
PubMed1992

Treatment of localized prostatic carcinoma using the transrectal ultrasound guided transperineal implantation technique.

Treatment of localized prostate cancer by ultrasonically guided transperineal 125I implantation, in contrast to open 125I implantation, may allow for ideal distribution of the seeds and may therefore lead to better treatment results. 46 patients with localized prostatic carcinoma (T1-T2, G1-G3, N0, M0) have been treated since 1985, using this new technique. The longest follow-up is 64 months (median 30 months). The irradiation implantation dose to the prostate was 160 Gy. Assessed by ultrasonography an average prostate volume reduction of 20% was achieved at 6 months, increasing to 24% at 12 months, 39% at 24 months and 56% at 48 months. To evaluate response of the primary tumor systematic ultrasonically guided needle biopsies from the previous malignant prostate areas were performed in all patients every 6 months during follow-up. Tumor-negative biopsies were obtained in 33% of patients at 12 months, 40% at 24 months, progressively increasing to 50% at 48 months. Three patients developed distant metastases, and 6 died, of whom 1 patient due to prostate cancer. Morbidity from implantation has been low and the erectile function was preserved in all patients at 12 months postimplantation. The high percentage of tumor-positive biopsies during follow-up indicates that this technique fails to cure a significant proportion of patients.

Aged↗
PubMed1992

Is preoperative transrectal ultrasonography of value in localised prostatic carcinoma? A blind comparative study between preoperative transrectal ultrasonography and the histopathological radical prostatectomy specimen.

Digital rectal examination (DRE) for staging is subjective and unreliable. Understaging has been reported in 25-72% and clinical overstaging of T3 tumors varies from 24-50%. In the present study of 15 patients, transrectal ultrasound (TRUS) staging was compared, in a blind comparative fashion, with pathological staging of the surgical specimen. Multifocal lesions were present in 8/15 patients (53%). A distinction was made between capsular involvement and 'clear' capsular penetration. TRUS was more sensitive in predicting capsular involvement than DRE (83% vs 17%), but the specificity was low (67% vs 100%). If capsular perforation was considered, the sensitivity and specificity of TRUS are 43% and 91%, respectively. Sensitivity and specificity for seminal vesicle tumor involvement by TRUS was 63% and 86%. Using TRUS the overall staging was improved by 33% compared with DRE and therefore TRUS is considered to be a valuable acquisition in localising and staging prostate cancer.

Aged↗
PubMed1990

Percutaneous transcatheter embolization of symptomatic renal angiomyolipomas: a report of four cases.

Successful percutaneous transcatheter embolization of renal angiomyolipoma is reported in four female patients. The angiomyolipomas measured more than 4 cm in diameter. Three patients had severe haemorrhage and one patient had a growing angiomyolipoma in a solitary kidney. This patient had percutaneous transcatheter embolization to prevent further deterioration of kidney function. Three patients had multiple renal angiomyolipomas as part of tuberous sclerosis. Two of them had selective transcatheter embolization of more than one angiomyolipoma. After embolization, one patient had partial loss of kidney function and one patient developed an abscess that could successfully be drained percutaneously under ultrasound guidance. The following conclusions can be drawn. All patients with tuberous sclerosis should be screened for renal angiomyolipomas. All symptomatic renal angiomyolipomas and all angiomyolipomas that measure more than 4 cm in diameter require treatment. Embolization should be considered as a primary therapeutic modality for multiple angiomyolipomas.

Adult↗
PubMed1989

Successful treatment of radiation cystitis with hyperbaric oxygen.

This report describes the results of hyperbaric oxygen therapy in 10 patients with radiation-induced cystitis. Severe macroscopic hematuria was present in all patients and was resistant to current therapy. Previously 8 patients had been treated for bladder carcinoma and 2 for prostatic carcinoma with 60 Gy radiotherapy. Hyperbaric oxygen therapy consisted of 20 sessions of 100% oxygen inhalation at 3 bar pressure for 90 min. In 6 patients the macroscopic hematuria stopped completely and it decreased in the other patients. These 4 patients had recurrent or residual bladder malignancies.

Aged↗
PubMed1988

Leiomyosarcoma of the renal vein: a case report.

We report a rare case of leiomyosarcoma of the renal vein. There have been only 5 other such cases reported in the literature. Special attention is focused on the diagnostic problems and the paucity of presenting symptoms. The literature is reviewed briefly.

Aged↗
PubMed1987

Randomized double-blind, placebo controlled safety study of a low molecular weight heparinoid in patients undergoing transurethral resection of the prostate.

In preparation for an efficacy study, the effect of the low molecular weight heparinoid Org 10172 on postoperative blood loss was assessed in a randomized double-blind, placebo controlled study in patients undergoing transurethral resection of the prostate (TURP). Org 10172 and placebo were given twice daily as i.v. injection for three postoperative days starting one hour preoperatively. Three doses of Org 10172 (800, 1600, and 2400 anti-Xa units b.d.) were evaluated against placebo in three consecutive patient blocks respectively. Each block consisted of 20 patients, 15 receiving Org 10172 and 5 patients placebo. The study was discontinued after 9 patients of the third block had completed the protocol because of excessive urinary blood loss. Data analysis showed a dose-dependent increase in postoperative haemoglobin loss, this was not significant for the 800 anti-Xa units b.d. dosage but was significant in those patients treated with 1600 (p less than 0.05) and 2400 anti-Xa units b.d. (p less than 0.01). It was concluded that the heparinoid Org 10172 caused a dose dependent increase in urinary blood loss following TURP.

Aged↗
PubMed1987

Adenocarcinoma of the kidney in childhood.

Renal adenocarcinoma in children is a rare tumor. A case report is presented and review of the available literature. There is no difference in symptomatology, therapy and prognosis between children and adults.

Adenocarcinoma↗
PubMed1986

Effects of extradural bupivacaine on the haemostatic system.

Twenty consecutive patients undergoing elective transurethral resection of the prostate were allocated randomly to one of two groups. Group I (n = 10) received lumbar extradural analgesia with 0.5% bupivacaine. Group II (n = 10) received general anaesthesia with spontaneous respiration, using 60% nitrous oxide and 1-2% halothane in oxygen. There was a significant inhibitory effect on platelet aggregation in the extradural group. No such effect was observed in the general anaesthesia group. Measured indices of coagulation and fibrinolysis showed no abnormalities compared with control in either group except for a significant decrease in alpha 2-antiplasmin during surgery in group II. These results suggest that the possible thromboprophylatic effect of extradural analgesia with bupivacaine may result from an inhibitory effect on platelet aggregation which is in addition to the increase in lower limb blood flow.

Anesthesia, Epidural↗
PubMed1985

The inverted urothelial papilloma.

3 additional cases of inverted urothelial papilloma are presented. A pathological, clinical and epidemiological review of this rare urothelial lesion is given.

Aged↗
PubMed1984

Microvascular surgical orchiopexy in the treatment of high-lying undescended testes.

Extensive laboratory experiments in animals have led us to believe that autotransplantation of the testis in the human is feasible. To date, nine of our patients (aged 4-13 years) with undescended intra-abdominal testes have undergone autotransplantation. Using a microvascular surgical technique to anastomose the testicular vessels to the inferior epigastric vessels, it has been possible to place the testis in a scrotal position in every case. No postoperative complications have been noted. Follow-up varied from 9 to 18 months and no atrophy of the testis was observed in this period. Doppler investigations on all of the transplanted testes continue to demonstrate good arterial flow. The aim of surgery on the undescended testis is not only to increase the chances of fertility and to diminish the possibility of malignant transformation but also, more importantly perhaps, to prevent possible abnormal psychosexual development in the child.

Adolescent↗
PubMed1984

Fibrous pseudotumor of the tunica vaginalis testis.

The incidence of fibrous pseudotumor of the tunica vaginalis testis is rare. It is a benign, fibroproliferative process with hyalinization and sometimes with focal calcification. In most cases malignancy is suspected although by careful physical examination it may be possible to establish the diagnosis pre-operatively. The best form of therapy is frozen section biopsy of the pseudotumor followed by excision; including if necessary the tunica vaginalis. If the pseudotumor is locally extensive an epididymectomy is sometimes necessary. A study of the literature reveals that because of the rarity of this lesion orchidectomy appears to have been performed in most cases. A case report of a patient with fibrous pseudotumor of the tunica vaginalis testis is presented.

Adult↗
PubMed1984

Effect of hormonal manipulation on antithrombin III activity in patients with prostatic carcinoma.

In three groups of patients with advanced prostatic cancer the influence of three different forms of hormonal manipulation, i.e. estrogens, anti-androgens and bilateral orchidectomy, on the coagulation and fibrinolytic systems has been investigated. The groups, studied over a period of 35 days, were comparable as to age and stage of malignancy. A significant decrease in antithrombin III (AT-III) activity of 27% (range 7-46%) was found in patients on an initially high-dose estrogen (diethylstilbestrol) treatment regime. No changes in any of the monitored coagulation and fibrinolytic parameters were noted in the other treatment groups, including patients on maintenance estrogen therapy. The results of this study show that only high-dose estrogen therapy is accompanied by a selective decrease in AT-III activity. This may be an important etiological factor in the increased risk of thromboembolism in patients treated by this regime. The other means of hormonal manipulation studied, including low-dose estrogen treatment, did not influence the coagulation or fibrinolytic systems.

Aged↗
PubMed1982

Estrogen-induced deficiency and decrease in antithrombin III activity in patients with prostatic cancer.

Plasma antithrombin III activity was studied in 22 patients with prostatic cancer who were on estrogen therapy. Normal plasma antithrombin III activity varies between 0.80 and 1.40 U. per ml. A loading dose of 15 mg. diethylstilbestrol daily resulted in a marked decrease in plasma antithrombin III activity (mean 0.24 U. per ml.). Patients with the lower end of normal range of pre-treatment plasma antithrombin III activity may suffer acquired antithrombin III deficiency and, thus, a concomitantly increased risk of thromboembolic complications as a result of estrogen treatment. Patients on maintenance therapy of approximately 1 mg. daily appear to have normal plasma antithrombin III levels. The results obtained suggest that plasma antithrombin III activity should be monitored before and during estrogen therapy in patients with prostatic cancer.

Aged↗
PubMed1978

Conservative surgical management of urological complications after cadaveric renal transplantation.

Review of a consecutive series of 85 cadaveric renal transplants revealed urinary fistulas in 7 cases. Bladder fistulas originated from the anterior cystostomy suture line in 3 patients and required secondary closure in every case. Ureteral fistulas from the donor ureter often required a multistaged operation. In every case the end result has been satisfactory, with closure of the fistula and preservation of renal function.

Cadaver↗
PubMed1976

A study of concentrations of trimethoprim-sulphamethoxazole in the human prostate gland.

The ability of trimethoprim (TMP) and sulphamethoxazole (SMX) components of co-trimoxazole to penetrate the human prostate gland was investigated. After a single 4-tablet dose TMP was evenly distributed between prostate and plasma, whereas SMX was mainly associated with plasma. Following a week's therapy significant accumulation of TMP was seen in the prostate relative to plasma whereas SMX although still associated with plasma had increased drug levels in prostate compared with the single dose study. It is concluded that co-trimoxazole produces effective antibacterial levels in the human prostate and has indications in the treatment of prostatitis.

Humans↗