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Biomedical subjects

A Sherif

Publications and source records attributed to A Sherif.

18 recordsLinked to original sources
PubMed2003

[Bladder cancer and the sentinel node concept].

PURPOSE: Lymph node status is one of the most important prognostic factors in muscle-invasive bladder cancer. The extent of lymphadenectomy performed in conjunction with cystectomy and the question as to whether this is a staging or therapeutic intervention are matters of discussion. The aim of this study was to evaluate the sentinel node (SN) concept and to correlate findings with tumour status in excised regional lymph nodes. MATERIAL AND METHOD: 26 patients scheduled for cystectomy were investigated with preoperative lymphoscintigraphy, peroperative dye detection (Patent Blue) and dynamic lymphoscintigraphy (Nanocoll or Albures 50 MBq/ml). The substances were injected adjacent to the tumour in the detrusor muscle. RESULTS: Sentinel nodes were detected in 21 of the 26 of the investigated patients. 7/21 SN were located outside the obturator fossa. Of the eight patients with lymph node metastasis, five displayed metastasis in lymph nodes outside the obturator fossa. There was one false negative SN in a patient with multifocal tumour, while in the other seven patients with lymph node metastasis, these were detected in the SN. CONCLUSION: Sentinel node detection is possible in most cases of bladder cancer scheduled for cystectomy. The significance of utilizing this method to detect lymph node metastasis outside the obturator fossa warrants further investigation.

Cystectomy↗
PubMed2003

[Transitional cell carcinoma of the prostate in cystoprostatectomy specimens].

PURPOSE: Transitional cell carcinoma (TCC) of the prostate/prostatic urethra is a risk factor for urethral recurrence after radical cystoprostatectomy for TCC. Using conventional sectioning techniques, prostate involvement (prostatic urethra, acini, ducts and/or stroma) has been detected in a range of 10-20% of the patients, whereas transversal whole mount sectioning has revealed 43 % prostate involvement in two reported series. Due to different mechanisms of prostate involvement (intraurethral, extravesical and direct overgrowth into the prostatic stroma), preoperative transurethral biopsies of the prostate might not accurately determine such involvement. In this study we examine the prostate using a longitudinal whole mount sectioning technique, correlate TCC of the prostate with the characteristics of the bladder tumour and, thus, validate the preoperative transurethral resection biopsies. MATERIAL AND METHODS: Patients scheduled for cystoprostatectomy or cystoprostatourethrectomy were investigated by preoperative resection biopsies from the prostatic urethra and mapping of the bladder. The cystectomy specimen was fixated with the bladder filled with formalin, and the prostate and bladder neck examined using longitudinal whole mount sectioning. RESULTS: In 13 of the 43 (30%), patients TCC was identified in the prostate. Of these 13 patients, 9 had been identified in the preoperative resection biopsies from the prostatic urethra. Of the patients with prostatic involvement, 46% had carcinoma in situ (Cis) in the bladder neck/trigone and 38% had multifocal Cis in the bladder. Comparing this to the group of patients without prostatic involvement, the respectively figures are 20% and 23%. A tumour in the trigone, either invasive or Cis, was detected in 5/13 patients with prostatic involvement as compared to one patient (3%) without TCC of the prostate. Multiple bladder tumours were more common in patients with prostatic involvement and were larger (3.2 cm compared to 2.2 cm). CONCLUSIONS: Preoperative resection biopsies from the prostatic urethra do not always detect TCC in the prostate. Cis in the bladder neck/trigone or multifocal and multiple bladder tumours could be risk factors for prostate involvement of TCC.

Biopsy↗
PubMed2002

Endovascular approach to treating secondary arterioureteral fistula.

Two patients with the rare entity of arterio-ureteral fistula are presented. Both highlight the predisposing factors of radiation, major surgery in the region, history of vascular surgery and presence of double-J-stent. Both patients presented with the clinical sign of intermittent gross hematuria. Both patients were successfully treated by endovascular intervention using graft covered stent.

Aged↗
PubMed2001

Arterio-ureteral fistula--a systematic review.

OBJECTIVE: To review published reports on arterio-ureteral fistula. METHOD: Literature search. RESULTS: Eighty cases were identified. Primary fistulas were mainly seen in combination with aortoiliac aneurysmal disease. Secondary fistulas were seen after pelvic cancer surgery, often with radiation, fibrosis and ureteral stenting or after vascular surgery with synthetic grafting. The dominating symptom is massive haematuria, often with circulatory impairment. The clue to a rapid and correct diagnosis is a high degree of suspicion. Most frequently diagnosis has been obtained through angiography or pyelography. When there is a ureteral stent manipulation it will often provoke bleeding and lead to diagnosis. The fistula must be excluded and a vascular reconstruction made. Most frequently this has been obtained through occlusion of the fistula and an extra-anatomic reconstruction (femoro-femoral crossover). Recently stent-grafting has been successfully used but follow-up is short. CONCLUSION: Arterio-ureteral fistula is rare and should be suspected in patients with complicated pelvic surgery and massive haematuria, especially where rigid ureteral stents have been placed.

Adolescent↗
PubMed2001

Pycnodysostosis: clinical, radiologic, and endocrine evaluation and linear growth after growth hormone therapy.

Pycnodysostosis is a rare hereditary bone abnormality with an autosomal recessive mode of inheritance. We report the clinical, radiologic, and endocrine status of 8 children with this rare disease. All patients had the characteristic phenotype of the disorder including short stature (8 of 8), increased bone density (7 of 8), separated cranial sutures (8 of 8), large fontanel with delayed closure (8 of 8), obtuse mandibular angle (8 of 8), delayed teeth eruption (8 of 8), enamel hypoplasia (7 of 8), dysplastic acromial ends of the clavicles (6 of 8), frontal bossing (6 of 8), ocular proptosis (8 of 8), and dysplastic nails (8 of 8). Developmental evaluation according to the revised Denever developmental screening showed normal motor, fine motor-adaptive language, and personal social abilities in all the children. All had normal hepatic and renal functions. Serum calcium and phosphorus concentrations were normal. Two children had low serum alkaline phosphatase concentration. Short stature is a characteristic feature of pycnodysostosis. Seven of the 8 children were born short (length standard deviation score [SDS] = -3 to -1.5). Deceleration of linear growth was significant during the first 3 years of life. All the children had height SDS below -3 at the end of their third year of life. Although short stature is a feature of this genetic disorder, defective growth hormone (GH) secretion in response to provocation with clonidine and glucagon was found in 4 of the 8 patients. These 4 patients had pituitary hypoplasia on the magnetic resonance imaging (MRI) of their brain. In addition, 3 of these 4 patients had demyelination of the cerebrum. Patients with pycnodysostosis (n = 8) had low circulating concentrations of insulin-like growth factor-1 (IGF-1) compared with normal age-matched short children with constitutional short stature (CSS). IGF-I increased significantly after injecting GH for 3 days in these patients. Physiologic replacement with GH (18 U/m(2)/week) divided in daily evening doses subcutaneously increased IGF-1 concentration and improved linear growth velocity and height standard deviation scores (HtSDS) in the 4 children with GH deficiency. These data ruled out GH resistance and proved the usefulness of GH therapy in the management of short stature in these patients. In summary, some patients with pycnodysostosis have partial GH deficiency and low IGF-1 concentration. GH therapy markedly increases IGF-I secretion and improves their linear growth. MRI study of the brain including the hypothalamic-pituitary area is recommended in these children because of the high incidence of pituitary hypoplasia and cerebral demyelination.

Adolescent↗
PubMed2001

Lymphatic mapping and detection of sentinel nodes in patients with bladder cancer.

PURPOSE: We examined the possibility for detecting sentinel nodes in patients with bladder cancer and whether the histopathological status of identified sentinel nodes reflected that of the lymphatic field. MATERIALS AND METHODS: A total of 13 patients with bladder cancer who met the criteria qualifying them for radical cystectomy had intravesical injections of radioactive tracer and blue dye marker around the tumor followed by lymphoscintigraphy to visualize lymphatic drainage and detect sentinel nodes. Sentinel nodes were identified preoperatively by the blue color and increased radioactivity and were compared histopathologically with other routinely excised lymph nodes. RESULTS: Sentinel nodes were detected in 85% (11 of 13) of patients. There were 4 patients who had sentinel nodes containing tumor cells, and each metastasis was only seen in the detected sentinel node. There were no false-negative sentinel nodes. Of the metastatic sentinel nodes 3 were located outside the normally excised lymph nodes of the obturator fossa. CONCLUSIONS: Sentinel nodes can be detected in patients with bladder cancer. The histopathological status of the identified sentinel nodes was diagnostic for all other excised lymph nodes. Sentinel nodes often seem to be located outside the obturator lymphatic field, which is normally examined during preoperative staging of bladder cancer.

Adult↗
PubMed1994

Prognostic factors and survival of patients aged less than 45 years with colorectal cancer.

Colorectal cancers in 92 patients aged 45 years and under presenting over a 20-year period (1970-1990) were studied. A delay of more than 4 months in presentation was seen in 27 per cent of patients. All underwent surgery, 14 per cent emergency and 86 per cent elective, and follow-up was available for 91 patients. Overall, 14 per cent of patients had Dukes A tumours, 32 per cent Dukes B, 36 per cent Dukes C and 18 per cent Dukes 'D'. Local recurrence occurred in eight (9 per cent) of the 92 patients and overall 5- and 10-year survival rates were 61 and 59 per cent. Multivariate analysis identified independent risk factors for local recurrence to be mucinous carcinoma (relative effect 4.9) and the presence of intramural vascular invasion by tumour (relative effect 9.4). For overall survival, independent risk factors were involvement of the regional lymph nodes by tumour (relative effect 2.0), extramural invasion by tumour cells (relative effect 3.0), tumour size (relative effect 1.8) and the presence of metastatic disease at initial diagnosis (relative effect 3.7).

Adolescent↗
PubMed1992

Risk of epilepsy after aneurysm operations.

This prospective study was undertaken to evaluate the risk of epilepsy after aneurysm operations. The patients were discharged after operation without any anticonvulsant prophylactic treatment and followed-up for 12 months. Out of 128 such patients 121 were submitted for final evaluation. Epilepsy was diagnosed if two or more seizure attacks occurred during that time. Such attacks occurred in 8 patients, so the risk of epilepsy was estimated at 7% for the 12 months after operation in patients without prophylactic treatment. In another 3 patients single seizures occurred during the follow-up, they were not treated with anticonvulsant drugs; seizures did not recur for up to two years. Detailed analysis of the patients with late epilepsy revealed that most of them were pre-operatively in the 3rd clinical group according to WFNS scale. The rationale for the use of prophylactic anticonvulsants after aneurysm surgery seems to be doubtful in view of this study and data from the literature.

Adult↗
PubMed1992

The repetitive vascular catastrophes of Behçet's disease: a case report with review of the literature.

Behçet's disease is a chronic, recurrent disease that most commonly presents as oral and genital ulcers and iritis. It is a multisystem disease with possible cardiovascular, pulmonary, neurologic, cutaneous and articular involvement. It is most often diagnosed in the 20 to 40 year age group, and vascular and neurologic involvement worsens the prognosis. Vascular manifestations include venous and arterial occlusions, arterial aneurysm and pseudoaneurysm formation. We present the case of a young man with Behçet's disease with multiple aneurysms, pseudoaneurysms, arterial occlusions and venous thrombosis with a literature review. Surgeons must consider Behçet's disease when dealing with aneurysms in young patients.

Adult↗
PubMed1991

Kimura's disease and membranous nephropathy.

An interesting association of Kimura's disease and membranous nephropathy is reported in a 71-year-old Chinese patient, 40 years after emigrating to the UK from Hong Kong. Significant blood eosinophilia and a very high serum IgE level were detected, the latter with a moderate level of specificity to Candida albicans. Light microscopy of renal biopsy was unremarkable despite a proteinuria of nephrotic proportions; diffuse subepithelial dense deposits compatible with membranous nephropathy were identified on electron microscopy. The atopic nature of Kimura's disease is confirmed and C. albicans is suggested as a possible causative agent.

Aged↗
PubMed1991

Bile duct carcinoma in Egypt: possible etiological factors.

Contrary to an old belief, bile duct carcinoma is not a rare disorder in Egypt. Among 730 patients referred for an ERCP examination, twenty-nine consecutive patients were diagnosed as having bile duct carcinoma. The cause of this type of carcinoma remains unknown. In the present study, only seven of the 29 (24.1%) with bile duct carcinoma patients had associated gallstones. In order to investigate the possible association between typhoid carrier state and bile duct carcinoma, stool cultures were performed for Salmonella typhi and Salmonella paratyphi A and B. Nine out of 23 patients (39.1%) with bile duct carcinoma, 17 out of 50 (34%) with calcular obstructive jaundice, and 1 out of 50 (2%) healthy individuals proved to be salmonella carriers. Statistical analysis of the results confirmed the presence of a significant association between chronic fecal thyphoid carrier state and bile duct carcinoma, while that between calcular obstructive jaundice and bile duct carcinoma was not significant. In conclusion, there might be an association between chronic fecal typhoid carrier state and bile duct carcinoma.

Adenoma, Bile Duct↗
PubMed1987

Drugs, insecticides and other agents from Artemisia.

Essential oils from Artemisia (wormwood) are of botanical and pharmaceutical interest. They are used in traditional remedies in many parts of the world. In pure form the oil is a narcotic poison. Nearly all species are intensively bitter and strongly aromatic. Extracted substances from the plant have an antibacterial action and some of these substances have potential use in mosquito control. Other properties include toxicity to nematodes and inhibition of seedling growth of. Several chemical compounds have been isolated and identified.

Anthelmintics↗
PubMed1982

[Experiences with the 1st 1400 posterior chamber lens implantations after phacoemulsification].

Since May 1979 the authors have performed 3000 posterior chamber lens implantations; the purpose of this report is to present interim data on the first 1400 cases. The mean age of the patient was 69 years; lens power was determined biometrically, and the diopter range of the implant lenses was between 10 and 30 D. Postoperatively 93.7% of the patients had a visual acuity of 0.5 or better, 70% between 0.8 and 1.0. Serious complications, such as corneal edema, lens luxation and expulsive choroidal hemorrhage have not occurred so far; slight complications such as decentration of the lens, secondary, glaucoma and synechiae have seldom been observed and have reacted favorably to therapy.

Aged↗
PubMedDate not supplied

[Caudal tumors as a rare cause of subarachnoid hemorrhage].

A case of cauda tumour (neurolemmona) is reported in which the presenting symptom was subarachnoid haemorrhage. The investigations for suspected cerebral vascular malformation brought no results. Only after appearance of clinical signs of cauda damage vertebral canal investigations made possible the correct diagnosis and proper treatment.

Adult↗