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Biomedical subjects

M Alami

Publications and source records attributed to M Alami.

At least 37 records · Page 2Linked to original sources

[Treatment of ureteral calculi with rigid ureteroscopy. Report of 67 cases].

PURPOSE: To evaluate the results obtained by rigid ureteroscopy to treat ureteral calculi. MATERIALS AND METHODS: Between May 1998 and September 2000, 63 patients underwent 67 rigid ureteroscopies (URS) with three endoscopic retreatments and one bilateral URS, for 48 distal, ten mid and nine proximal ureteral calculi. RESULTS: After URS 77.6% of the patients were free of the stones. Success rate was respectively 85.4%, 60% and 55.5% in distal, mid and proximal uretero. Morbidity was 10.4% and there have been one stricture treated by endoscopy. CONCLUSION: Our series demonstrates that rigid URS is safe and effective procedure to treat distal, ureteral calculi. Thus, it should be considered a treatment of choice for distal ureteral calculi.

Adult↗

Characterisation of the gene encoding the alpha-toxin Amm V from the scorpion Androctonus mauretanicus mauretanicus.

The full-length cDNA encoding the scorpion alpha-toxin Amm V was amplified from a cDNA library produced from the venom glands of the scorpion Androctonus mauretanicus mauretanicus from Morocco. We deduced the amino acid sequence of the encoded precursor protein and found that the mature toxin was similar to the previously characterised toxin. The genomic DNA sequence encoding the toxin was also amplified, subcloned and sequenced. This also led to the isolation of a new Amm V related-gene. Then, for the first time, we studied changes in the level of toxin mRNA synthesis over time.

Amino Acid Sequence↗

[Endosomes and toxin translocation].

In this review we discuss data obtained by our group regarding the entry of toxins, especially ricin, diphtheria toxin (DT) and Pseudomonas exotoxin A (PE) into animal cells. We studied the translocation process of these toxins using endosomes purified from lymphocytes. This process is rate-limiting for toxicity and enables these toxins to reach the cytosol where they will inactivate the protein synthesis system and kill the cell. We could show that each of these toxins uses a different strategy to cross the endosome membrane. Whereas ricin transmembrane transport only relies on cytosolic ATP hydrolysis, PE first requires exposure to the low endosomal pH (pH-6), presumably to insert into the endosome membrane, before being translocated via a process which also requires cytosolic ATP hydrolysis. DT translocation is directly triggered and energized by the endosome-cytosol pH gradient. Using conjugates with dihydrofolate reductase we could indirectly show that ricin and PE require unfolding for translocation. A deletion approach enabled to produce a more cytotoxic PE mutant by increasing its translocation activity.

ADP Ribose Transferases↗

[Sarcomatoid carcinoma of the prostate].

The authors report a case of sarcomatoid carcinoma of the prostate in a 49-year-old patient. The clinical symptoms were dominated by dysuria and frequency. Digital rectal examination showed a very large, hard and irregular prostate. Serum PSA was normal. Transrectal ultrasonography and abdominopelvic computed tomography showed a heterogeneous mass occupying the vesico-prostatic junction. The patient underwent cystoprostatectomy. Histological examination of the cystoprostatectomy specimen revealed a tumour composed of spindle cells expressing epithelial markers on immunohistochemical analysis and concluded on a diagnosis of sarcomatoid carcinoma of the prostate. The patient died seven months after cystoprostatectomy.

Carcinosarcoma↗

[Syringocele: report of 2 cases].

Cowper's syringocele, dilatation of bulbo-urethral glands, is a rare disease, usually congenital. The authors report two cases of perforated syringocele and analyse the clinical, radiological and therapeutic aspects of this disease.

Adult↗

[Subcapsular spontaneous hematoma of the kidney of non-tumor origin (report of 5 cases)].

Spontaneous subcapsular haematoma (SCH) of the kidney is a rare condition, secondary to kidney tumours in more than 50% of cases. Nephrectomy is justified in the presence of tumour or uncontrolled haemorrhage. When the aetiology cannot be determined, thin-slice CT follow-up of the patient's kidney can be performed. The authors report 5 cases of SCH of the kidney. A retropelvic aneurysm was responsible for the haematoma in one case; polyarteritis nodosa was the cause of bleeding in another case and the aetiology could not be determined in two cases. All patients were managed surgically. Nephrectomy was performed in 3 cases and simple evacuation of the haematoma was performed in 2 cases.

Adult↗

[Paraganglioma associated with gastric schwannosarcoma].

The authors report the case of a 45-year-old patient who presented with a left latero-aortic paraganglioma associated with gastric schwannosarcoma. Treatment consisted of resection of the chromaffin tumour and the gastric tumour, with a favourable course at last follow-up. The authors review the literature on this subject.

Humans↗

[Emphysematous pyelonephritis in lithiasic kidney caused by acinetobacter].

Emphysematous pyelonephritis is rare. It is exceptionally associated with urolithiasis with obstruction of the collecting system. It is generally observed in female diabetic patients. It is caused by gas-producing bacteria. We report a case in which emphysematous pyelonephritis was caused by an acinetobacter, associated with pelvic ureteral junction lithiasis. Drainage and nephrectomy were necessary to overcome this life threatening situation.

Acinetobacter Infections↗

[Malignant adrenal cortical neoplasms. Report of 22 cases].

OBJECTIVES: Analysis of the treatment of a series of patients with adrenal cortical carcinoma. MATERIAL AND METHODS: This series consists of 22 patients (15 women and 7 men) with a mean age of 35 years (range: 23 to 58 years). 55% of patients had a non-secreting tumour; 45% of tumours were associated with excessive hormonal secretion. The tumour was located on the right side in 12 cases and on the left side in 11 cases (the tumour was bilateral in 1 case). Ultrasound and CT were sufficient for localization of the tumour. The patients were classified as stage I: 3 cases, stage II: 2 cases, stage III.: 8 cases, stage IV: 9 cases, according to MacFarlane's classification. RESULTS: Adrenalectomy was performed in 18 patients. Two patients died during the operation and another 8 died within the first four years. Eight patients are currently alive, including 7 with no signs of recurrence; one patient presented a large local recurrence 39 months after adrenalectomy. CONCLUSION: Surgery remains the only effective treatment at the present time. The diagnosis of adrenal cortical carcinoma must be made as early as possible.

Adrenal Gland Neoplasms↗

[Retroperitoneal liposarcoma. Report of 3 cases].

We report three cases of retroperitoneal liposarcoma. Two patients required multiple surgical excisions for locoregional relapse diagnosed by surveillance based on CT-scan. One patient had radiotherapy. With the literature review we discuss the pathologic and therapeutic aspects of these lesions.

Aged↗

[Urinary candidiasis revealed by ureteral obstruction: report of 2 cases].

There has been an increase in the frequency of candidiasis urinary infections, which mainly affect diabetic or immunodepressed patients. However, the obstruction of the upper urinary tract by fungal infection is a rare occurrence. The introduction of novel antifungal agents has improved the treatment of fungal infection. In this study, two cases have been reported of urinary candidiasis infections with obstruction of the upper urinary tract which were successfully treated with fluconazole in combination with ureteral catheterization.

Adult↗

[Adrenal gland ganglioneuroma].

The authors report a case of adrenal ganglioneuroma in a 25 year old woman. This rare and benign tumor is localized in the adrenal gland in 20% of cases. Considerations on diagnosis, pathogenesis and management are discussed.

Adrenal Gland Neoplasms↗

A deletion within the translocation domain of Pseudomonas exotoxin A enhances translocation efficiency and cytotoxicity concomitantly.

Pseudomonas exotoxin A (PE) is a cytotoxin composed of three structural domains. Domain I is responsible for cell binding, domain II for membrane translocation enabling access to the cytosol, and domain III for the catalytic inactivation of protein synthesis, which results in cell death. To investigate the role of the six alpha-helices (A-F) that form the translocation domain, we deleted them successively one at a time. All mutants showed native cell-binding and catalytic activities, indicating that deletions specifically affected translocation activity. This step of the intoxication procedure was examined directly using a cell-free translocation assay, and indirectly by monitoring cytotoxicity. Translocation activity and log(cytotoxicity) were highly correlated, directly indicating that translocation is rate limiting for PE intoxication. Deletion of B, C and D helices resulted in non-toxic and non-translocating molecules, whereas mutants lacking the A or E helix displayed significant cytotoxicity albeit 500-fold lower than native PE. We concluded that B, C and D helices, which make up the core of domain II, are essential, whereas the more peripheral A and E helices are comparatively dispensable. The last helix (F) is inhibitory for translocation because its deletion produced a mutant displaying a translocation activity 60% higher than PE, along with a three- to sixfold increase in cytotoxicity in all tested cell lines. This toxin is the most in vitro active PE mutant obtained until now. Finally, partial duplication of domain II did not give rise to a more actively translocated PE, but rather to a threefold less active molecule.

ADP Ribose Transferases↗

[Adrenal gland pheochromocytoma. Report of 26 cases].

The authors analyse of a series of 26 patients (17 females and 9 males) with a mean age of 32 years (range: 18 to 55 years) operated for adrenal phaeochromocytoma. All patients were hypertensive. The laboratory assessment (assay of blood catecholamines and urinary catecholamine metabolites) performed in more than 2/3 of cases confirmed the diagnosis in more than 80% of cases. The topographic diagnosis was facilitated by computed tomography. Fifteen patients received preoperative treatment with alpha-blockers or calcium channel blockers. Various incisions were used, but a lumbar incision was the most frequent. Blood pressure was controlled postoperatively in 24 patients. Two patients died 1 and 2 postoperatively. New diagnostic modalities (CT, MRI) have facilitated the diagnosis and the site of localization of phaeochromocytomas, thereby improving the choice of incision. Patient-specific preoperative preparation and appropriate anaesthesia facilitate successful adrenal gland surgery.

Adolescent↗

[Thyroid cancer metastasizing to the kidney. Report of a case].

The authors report a case of renal metastasis from a thyroid adenocarcinoma in a 56-year-old man, occurring 3 years after isthmolobectomy for papillary thyroid carcinoma. He predominant clinical symptoms were low back pain, haematuria and deterioration of the general state. Ultrasonography showed a hypoechoic left renal mass, 56 mm in diameter, with a thickened wall. Renal CT showed a homogeneous low-density formation with a thickened wall in the left kidney. Iodine 131 whole body scan showed increased uptake in the left kidney. The patient wes treated surgically via a subcostal incision. The surgical procedure consisted of radical nephrectomy. Macroscopic examination of the lesion showed a cystic mass. Histological examination of the mass revealed a renal metastasis from moderately differentiated thyroid adenocarcinoma.

Adenocarcinoma↗

[The Martius flap in the treatment of vesicovaginal fistulas. Report of 20 cases].

The authors report a series of 20 cases of vesicovaginal fistula (VVF) treated according to the Martius procedure. The mean age of the patients was 30 years (range: 20 to 37 years). All fistulas were secondary to obstetric trauma. The mean diameter of the fistula orifice was 4 cm. Fourteen fistulas were cervico-trigonal and 6 were urethro-cervico-trigonal. A rectovaginal fistula was associated with VVF in 2 patients. Five of the 20 patients had never been previously operated, while 15 patients had already been operated without success. Fifteen patients were cured immediately, while a second Martius procedure was necessary in 3 cases. Failure was considered to be definitive in 2 cases.

Adult↗