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Biomedical subjects

A Mostafa

Publications and source records attributed to A Mostafa.

16 recordsLinked to original sources
PubMed2006

Methylene blue dye versus combined dye-radioactive tracer technique for sentinel lymph node localisation in early breast cancer.

AIM: The study compared the accuracy and success rate of two techniques, methylene blue alone versus combined methylene blue and radioactive colloid in sentinel lymph node localisation in the management early breast cancer. METHODS: Three hundred and twenty-nine patients with tumours less than 2 cm on ultrasound assessment were prospectively evaluated. One hundred and seventy-three patients (Group A) underwent sentinel lymph node localisation using 1 ml of 1% methylene blue. A combined technique of both methylene blue and radioactive colloid was used in 156 patients (Group B). Application of both was subdermal and subareolar. Sentinel lymph nodes were examined by standard microscopy. Patients underwent breast conservation surgery or mastectomy and sentinel node guided four node axillary sampling+/-clearance. RESULTS: In Group A, the sentinel lymph node identification rate was 96.5%. The negative predictive value was 96.3%, with false negative of 3.7% and accuracy of 87.4%. In group B the identification rate for sentinel lymph node was 98.7%, with false negative of 4.1%, negative predictive value of 96%, and accuracy of 83.8%. CONCLUSION: Sentinel lymph node localisation using methylene blue or combined dye and radioactive tracer technique predicts the axillary lymph node status in early breast cancer with comparable success rates, accuracy and false negative rates. The combined technique facilitates quicker identification of sentinel lymph node; however the dye technique alone can be used successfully in centres without nuclear medicine facilities.

Axilla↗
PubMed2004

Effect of total abdominal hysterectomy on pelvic floor function.

Historically, hysterectomy is one of the oldest gynecologic operations, dating back to the 1840s. Currently, it is the most common gynecologic operation performed and is associated with marked improvement in the patients' quality of life. It is widely considered a safe procedure with an extremely low mortality rate (<0.1%). The majority of hysterectomies are done abdominally, with the vast majority being total abdominal hysterectomies. The effect of hysterectomy on pelvic floor function has been a subject of long debate. Various studies have reached different and rather contradictory results. Most of these studies lack stringent methodologic standards, being retrospective, observational, or uncontrolled. A recent excellent study assessed the effect of abdominal hysterectomy on pelvic floor function as 1 functional unit and concluded that both total and subtotal abdominal hysterectomies have no detrimental effect on the pelvic floor function up to 1 year postoperatively.

Autonomic Nervous System↗
PubMed2000

Release of glutamate and GABA in the amygdala of conscious rats by acute stress and baroreceptor activation: differences between SHR and WKY rats.

To reveal the functional importance of amino acid neurotransmission in the amygdala (AMY) of conscious spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats, the in vivo release of glutamate (GLU) and GABA in this brain structure was studied using the push-pull superfusion technique. Basal GLU and GABA release rates in the AMY were comparable in SHR and WKY rats, although arterial blood pressure (BP) in SHR (152+/-6 mmHg) was higher than in WKY rats (102+/-4 mmHg). Neuronal depolarization by superfusion with veratridine enhanced the release of GLU and GABA to a similar extent in both rat strains. On the other hand, exposure to noise stress (95 dB) for 3 min led to a tetrodotoxin-sensitive increase in GLU release in the AMY of SHR, but not WKY rats. The concurrent pressor response to noise was enhanced in SHR as compared to WKY rats. A rise in BP induced by intravenous infusion of phenylephrine for 9 min had no effect on amino acid release in the AMY of both strains. The data suggest an exaggerated stress response of glutamatergic neurons in the AMY of SHR as compared with WKY rats, which might be of significance for the strain differences in the cardiovascular and behavioural responses to stress. The results also show that, in both rat strains, glutamatergic and GABAergic neurons in the AMY are not modulated by baroreceptor activation. Moreover, hypertension in adult SHR does not seem to be linked to a disturbed synaptic regulation of glutamatergic or GABAergic transmission in the AMY.

Amygdala↗
PubMed2000

Is dissection of the internerve tissue during axillary lymphadenectomy for breast cancer necessary?

AIMS: The study evaluates the necessity of dissecting the tissue between the long thoracic and thoracodorsal nerves (internerve tissue) during axillary dissection in breast cancer surgery. By reviewing the lymph node yield and the metastatic rate in the internerve tissue, we examine whether the internerve tissue could be left in situ to minimize the risk of nerve injury. METHODS: A prospective study was conducted on 30 consecutive women undergoing axillary lymphadenectomy for breast cancer. The internerve tissue remaining was excised separately after a routine axillary dissection and was examined by the same pathologist. RESULTS: Twenty (67%) of 30 internerve specimens contained lymph nodes; the internerve nodes were positive for carcinoma in three cases (10%). In one case the lymph node in the internerve tissue was the only metastatic node in the axilla. CONCLUSIONS: There is a significant incidence of lymph nodes (67%) and axillary node metastases (10%) in the tissue lying between the long thoracic and thoracodorsal nerves. Therefore excision of this internerve tissue is strongly recommended in order to optimize decision making regarding adjuvant treatment and oucome in women with operable breast cancer.

Adult↗
PubMed1999

Phyllodes tumour of the breast: a retrospective analysis of 30 cases.

Phyllodes tumour (PT) is a rare neoplasm of the female breast that resembles fibroadenoma but occurs in an older age group. We retrospectively reviewed the medical records of 30 women who were treated for phyllodes tumour in our centre. Histological examination was performed by an experienced breast pathologist in all cases and tumours were classified as benign, border line malignant or malignant according to standard histological criteria. The mean age at diagnosis was 49 years (range: 19-80 years). Twenty-one (70%) of 30 tumours were benign and 9 (30%) were malignant (n=7) or borderline malignant (n=2). The mean tumour size was 46 mm (range: 20-100 mm). The final microscopic margins contained tumour in 13 (43%) of 30 cases and were free of tumour in 17 (57%) of 30 patients. After a median follow-up period of 6 years (range: 6 months-20 years), the tumour recurred locally in 5 (17%) patients. One patient had six local recurrences over an 18-year period. Local recurrences were more frequently observed in patients with malignant tumours compared with those with benign lesions (33% versus 10%). However, this association failed to reach statistical significance. There was no association between local recurrence, patient age, tumour size or positive microscopic margins. There was one death (3%) associated with a completely excised malignant tumour. The present study suggests that histological type and margins do not accurately predict the clinical course of PT and that there is a need to identify novel biological markers that more accurately predict the behaviour of this rare neoplasm.

Journal Article↗
PubMed1999

Radial scar and carcinoma of the breast: microscopic findings in 32 cases.

We retrospectively reviewed the microscopic findings in 32 histologically confirmed radial scars in 31 women diagnosed in our unit during 1994-1998. The median age at diagnosis was 53 years (range 47-63 years). Thirty-one (97%) of 32 lesions presented as screen detected mammographic abnormalities (28 stellate lesions, 2 microcalcifications and only 1 architectural distortion). One lesion presented as a palpable breast mass. Stereotactic or ultrasound-guided fine needle aspiration cytology (FNAC) was performed in 28 cases. Cytological analysis of FNAs revealed malignant cells (C5) in 8 (29%) cases, highly suspicious cells (C4) in 3 (11%) cases, atypical benign cells (C3) in 7 (25%) cases and benign epithelial cells (C2) in 10 (35%) cases. All non-palpable lesions were surgically excised following wire localization. Histological examination of the breast specimens (mean weight=16 g) demonstrated, in addition to a radial scar, 6 invasive carcinomas (2 infiltrating ductal, 2 tubular, 1 mixed ductal/lobular and 1 secretory carcinoma) and 4 ductal carcinoma in situ lesions (2 high grade, 1 high grade with micro-invasion and 1 low grade) arising in the radial scar. Of the remaining cases the radial scar was associated with atypical epithelial hyperplasia in 2 cases and regular epithelial hyperplasia in 17 cases (4 florid and 13 mild to moderate). In the 10 cases associated with malignancy, 9 had FNAC and was reported as malignant (C5) in 6 (67%) cases, highly suspicious (C4) in 2 (22%) cases and atypical (C3) in 1 (11%). False positive FNAC (C5) occurred in two patients, one of whom presented with pleomorphic microcalcifications suggestive of ductal carcinoma in situ. This patient was treated with a wire guided segmental mastectomy. All invasive tumours were less than 20 mm in size (T1) and of these 4 were grade I and 2 were grade II. Axillary dissection was performed in 4 patients none of whom had axillary node metastases. Our study demonstrates a significant incidence of malignancy associated with radial scars (31%) suggesting that radial scars may be premalignant lesions. This is supported by detecting various stages of mammary carcinogenesis (atypical epithelial hyperplasia, ductal carcinoma in situ, and early invasive malignancy) in these lesions. Fine needle aspiration cytology seems to be unreliable in the diagnosis of radial scar associated malignancy (67% sensitivity and 91% specificity). Stellate lesions, therefore, should be excised to obtain an histological diagnosis regardless of cytological findings. Further studies examining the biology of radial scars are required.

Journal Article↗
PubMed1998

Urinary bladder bilharziasis as a cause of impaired bladder muscle contractility.

In an attempt to evaluate the effect of bilharziasis on bladder contractility as a factor in the genesis of voiding disorders, 44 cases of bilharzial bladder neck obstruction diagnosed using traditional methods (symptomatological, radiographic, and endoscopic) were subjected to complete urodynamic evaluation (flowmetry, cystometry, pressure/flow study, and stop-flow test). Their parameters were compared with those of 28 patients with urodynamically obstructed benign prostatic hyperplasia and 8 nonsymptomatic controls. Contractility parameters (isometric detrusor pressure, maximum estimated flow rate, detrusor power at maximum flow) were calculated for the studied cases and their distribution according to the Schafer pressure/flow diagram was evaluated. Bladder biopsy including the detrusor was evaluated in all 72 patients. Poor bladder contractility associated with an extensive bilharzial effect on the detrusor muscle was found to be the major abnormality in 20 of 44 patients with presumed bilharzial bladder neck obstruction with no evidence of urodynamic outflow obstruction. We believe such a workup is essential in cases of suspected obstruction associated with bilharziasis to throw light on the pathophysiology of the voiding disorders, avoid unnecessary surgery, and provide a better prognosis.

Adult↗
PubMed1996

A comparative study of serological techniques for detection of West Nile virus antibodies.

This study was conducted to compare different serological techniques namely enzyme-linked immunosorbent assay (ELISA), hemagglutination inhibition (HI), indirect immunofluorescence (IFT) and plaque reduction neutralization (PRNT), for detection of West Nile virus (WNV) antibodies in sera collected from inhabitants of a flooded village (Begiram, Minufiya Governorate). ELISA showed 45% while HI and IFT indicated 37.6 and 26.4% positive sera among the tested 178 sera taken from the flooded village, respectively. The results obtained by ELISA, HI and IFT of only 55 randomly chosen sera were compared with their PRNT results. ELISA was found to be more sensitive (83.8%) while IFT and HI were more specific (88.9% and 83.3%, respectively). The positive predictive values for the 3 tests were more than 80% while the negative predictive values were different for these tests: 66.7% for ELISA, 44.1% and 37% for HI and IFT, respectively. From this study it is concluded that for screening of population in an endemic area, two serological tests in combination can be used starting with ELISA (the more sensitive) followed by HI and/or IFT (the more specific) to exclude the false positive results.

Antibodies, Viral↗
PubMed1993

Testicular morphology and function in varicocele patients: pre-operative and post-operative histopathology.

The organic effects of varicocele on testicular histology were studied in bilateral testicular biopsies obtained from 30 infertile men during varicocele repair and 3 to 6 months post-operatively, using light microscopy. Before surgery and at follow-up, semen analyses were performed. The results showed a substantial improvement in semen quality in 22 cases post-operatively. Pre-operative biopsies showed depressed spermatogenesis with a predominant picture of maturation arrest, sloughing of spermatogenic epithelium, an increase in Leydig cells, thickening of tubular basement membranes and interstitial blood vessel walls with narrowing of their lumina, and increased deposition of interstitial fibrous tissue. Post-operatively, spermatogenesis improved in 22 cases, with increased mean tubular scores together with diminution in epithelial cell sloughing. The increased prominence of Leydig cells reverted to normal in 18 cases. The changes in tubular basement membranes, interstitium and interstitial blood vessels were unaffected.

Adult↗
PubMed1989

Inhibin and reproduction. First communication: changes to inhibin level in Barki ewes after artificial infection with bluetongue virus.

Bluetongue virus type 16, isolated from sheep in Egypt, was injected to 4 normally cycling Barki ewes and caused high levels of inhibin. This was assayed by a biological method, using suppression of the luteinising hormone (LH) of castrated rats. Albumin (fraction 2) was injected to normally cycling ewes. The sera of injected ewes were investigated 1 day after injection and weekly up to the 4th one injection. There was a gradual decrease of LH (4.8 +/- 0.52 I.U./ml serum) until the minimum level (1.17 +/- 0.25 I.U./ml serum) was reached, in comparison to the control serum LH which was 5.26 +/- 0.52 I.U./ml serum during the dioestrous phase.

Anestrus↗
PubMedDate not supplied

Effect of high-dose intravenous immunoglobulin on suppression of alloantibodies against hla in highly sensitized transplant candidates.

Sensitization can present a virtually insurmountable barrier to kidney transplantation. Ten to twenty percent of patients on waiting lists for renal transplantation have developed broadly reactive cytotoxic antibodies against HLA antigens caused by pregnancy, blood transfusion, or a prior failed allograft. These sensitized end-stage renal disease patients often wait more than 5 years for a kidney to be offered. Potent immunosuppressives, plasma exchange and/or immunoadsorption have been used but the risk of infection limited their use. Some reports, have demonstrated in small numbers of patients the use of Intravenous Immunoglobulin (IVIG) as potential modality for the treatment of these sensitized patients. The goal of this study was to investigate the extent of the efficacy and to assess the utility of this modality of treatment on a relatively larger number of patients. The study included 11 patients with end stage renal disease who were waiting for living related renal allotransplantation. All patients had persistently positive crossmatches with their living related donors and PRA titer >/=20%. They received IVIG for a period of two weeks and a total of 6 doses. None of these patients, however, attained significant suppression of anti-HLA antibodies titer or a negative crossmatch reaction. We found that IVIG alone couldn't effectively inhibit preformed anti-HLA antibodies to allow successful renal transplantation.

Adult↗