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Biomedical subjects

G Laungani

Publications and source records attributed to G Laungani.

4 recordsLinked to original sources
PubMed1992

Initial experience with therasonic lithotriptor.

Piezoelectric shock wave lithotripsy has been shown to offer a low-cost, safe, anesthesia-free yet effective means of disintegrating urinary calculi. The Therasonic lithotriptor combines proprietary piezoelectric shock wave technology for effective stone fragmentation with a multi-purpose urologic table and both fluoroscopic and ultrasound imaging for accurate stone localization and real-time treatment monitoring. From December 1, 1988 to November 15, 1989, 138 patients with 172 calculi were treated (94.2% were intrarenal, 5.8% were in ureter). All stones greater than or equal to 4 mm were considered suitable for treatment. Lithotripsy was performed under intravenous sedation except when ancillary procedures were necessary. For evaluation of device effectiveness, 94 patients were available with follow-up greater than or equal to thirty days. Successful fragmentation (stone free or residual debris less than or equal to 4 mm) was achieved in 97 percent of patients. The retreatment rate for stones 0.5-2.0 cm was 11 percent, and the overall retreatment rate was 21.2 percent regardless of stone size. Complications were minimal, transient, and resolved spontaneously.

Adult↗
PubMed1990

Treatment of advanced transitional cell carcinoma of the bladder with irradiation and concomitant 5-fluorouracil infusion.

Twenty patients with advanced transitional cell carcinoma of the bladder were treated with radiation and concomitant continuous infusion of 5-fluorouracil with or without Mitomycin. Nineteen of 20 patients were assessed for response. Fourteen of 19 patients (74%) obtained a complete response within 3 to 6 months. An additional three patients (15%) acquired and maintained a complete response after local transurethral resection of the tumor and intravesical chemotherapy, raising the overall complete response (CR) rate to 17/19 (89%). Of the two patients with persistent disease, one is alive and well after salvage cystectomy. Eighteen of 20 patients were evaluated for survival with a median follow-up of 38 months. Seven patients remain alive and well 51 to 78 months, whereas three patients died from intercurrent disease. Eight patients died of either distant metastatic disease (7 patients) or regional disease (1 patient). An adjusted survival calculated by the Life Table Method was 53.6% at 5 years, whereas the overall survival was 39%. The combined modality therapy was well tolerated with no need for treatment interruption or reduction in dose. Late bladder complications include one patient with hemorrhagic cystitis, two patients with dysuria, and two with symptoms of irritable bladder. One patient required a colostomy for a chronic hemorrhagic proctitis. Bladder preservation was achieved in 19/20 patients.

Aged↗
PubMed1989

Utero vaginal malformations: a trap for the unsuspecting surgeon.

Eighteen girls with major uterovaginal malformations were admitted to the Pediatric Surgical Service over a 17-year period. The diagnosis was not suspected or delayed in more than one half of the patients. The encountered anomalies were divided into four groups: I, isolated uterovaginal malformations (UVM) (4); II, UVM with anorectal anomalies (8); III, UVM with cloacal (urogenital sinus) abnormalities (5); and IV, caudal twinning (1). Imperforate hymen, vaginal web, low vaginal obstruction, or disorders of gonadal or chromosomal development were excluded. Patients presented with an abdominal mass or distension (5), abdominal pain (4), "sciatic"-like pain (1), purulent vaginal discharge with perineal pain (1), amenorrhea (2), and a pelvic and prerectal mass (1). The introitus was reported as normal in 11 patients with vaginal atresia or agenesis by the primary physician. Diagnostic studies, in addition to clinical and endoscopic examination, included routine radiological workup, genitourinary contrast studies, pelvic and perineal sonography, computerized tomography (CT) scanning, and more recently, magnetic resonance imaging. In complicated UVM, especially vaginal duplications with unilateral atresia, the CT scan was the most helpful diagnostic tool. Laparotomy was necessary, not only for therapeutic, but diagnostic reasons; even so, complex anomalies, such as vaginal duplication with unilateral atresia and a septate uterus, could not be suspected. Treatment was directed toward the restoration of a functional uterovaginal tract and the frequently associated anorectal anomalies. A review indicated that contrary to our expectations, the major UVM occurred in children with a low imperforate anus rather than the high variety.

Abnormalities, Multiple↗