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Biomedical subjects

M M Issa

Publications and source records attributed to M M Issa.

At least 37 records · Page 2Linked to original sources
PubMed1997

Routine transition zone and seminal vesicle biopsies in all patients undergoing transrectal ultrasound guided prostate biopsies are not indicated.

PURPOSE: Transrectal ultrasound guided biopsies of the transition zone and seminal vesicles have been useful in select patients. More widespread use of these additional biopsies has been proposed. The efficacy of routine transition zone and seminal vesicle biopsies was examined. MATERIALS AND METHODS: From January 1988 to October 1994, 736 transrectal ultrasound guided systematic sextant biopsies were performed. From October 1994 to July 1995, 161 consecutive patients underwent transrectal ultrasound with systematic sextant, transition zone and seminal vesicle biopsies. RESULTS: Of the 736 patients undergoing only sextant biopsies 309 (42.0%) had cancer and 24 (3.3%) required repeat biopsy, compared to 55 (34.2%) and 4 (2.5%) of 161 undergoing combined sextant, transition zone and seminal vesicle biopsies. Prostate cancer was found only in the systematic sextant biopsies in 43 of the former 55 patients (78.2%), and in the transition zone and systematic sextant biopsies in 11 (20.0%). One patient (1.8% of patients with cancer or 0.6% of all 161 patients) had cancer in only the anterior biopsies and 6 (10.9 and 3.7%, respectively) had cancer involving the seminal vesicles. CONCLUSIONS: Routine transition zone and seminal vesicle biopsies in all patients undergoing transrectal ultrasound guided systematic sextant biopsies are not warranted.

Aged↗
PubMed1996

Transurethral needle ablation of the prostate: report of initial United States clinical trial.

PURPOSE: We studied the efficacy and safety of transurethral needle ablation of the prostate for treatment of symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 12 patients with symptomatic BPH underwent transurethral needle ablation of the prostate. Voiding outcomes, including American Urological Association symptom scores, bother scores, bother scores, quality of life scores, peak urinary flow rates, residual urine volumes and urodynamic pressure flows, were measured with time, and immediate and short-term (6 months) complications were assessed. RESULTS: Transurethral needle ablation of the prostate was performed with local intraurethral lidocaine anesthesia in 11 patients and general anesthesia in 1. At 6 months there was a 61.7% improvement in American Urological Association symptom score (25.6 to 9.8, p = 0.0001), 61.1% improvement in bother score (18.8 to 7.3, p = 0.0002), 70.0% improvement in quality of life score (13.7 to 4.1, p = 0.0001), 73.0% increase in peak flow rate (7.8 to 13.5 cc per second, p < 0.0001) and 54.9% decrease in the post-void residual (111 to 50 cc, p = 0.0457). Prostate volumes, maximum detrusor pressures and detrusor opening pressures decreased significantly. There were no intraoperative complications. Postoperatively, all 12 patients had mild dysuria for 1 to 7 days, 5 had transient urinary retention for 1 to 4 days, 3 had hematuria for 1 to 2 days and 1 had retrograde ejaculation. CONCLUSIONS. This initial United States trial confirms previous experience, and shows that transurethral needle ablation of the prostate appears to be a simple, safe and efficacious procedure for treatment of symptomatic BPH. In addition, it can be performed in the majority of patients using topical urethral anesthesia.

Aged↗
PubMed1995

Insight into mechanism of neodymium: yttrium-aluminum-garnet laser prostatectomy utilizing the high-power contact-free beam technique.

OBJECTIVES: The objective of this study was to define the actual mechanism of neodymium: yttrium-aluminum-garnet (Nd:YAG) laser prostatectomy achieved with the previously described contact-free beam technique using the Ultraline delivery system at high-power settings. METHODS: Transurethral Nd:YAG laser application was performed with the Ultraline side-firing laser fiber in canine and human prostates. Total or radical prostatectomy was performed after laser treatment to examine and measure laser tissue effects produced using the contact-free beam technique. RESULTS: Minimal actual tissue evaporation or vaporization was noted in either the canine or human prostate using this technique. The extent of tissue vaporization achieved was probably insufficient to produce clinically significant voiding outcomes acutely or chronically. However, this technique, using the Nd:YAG laser, produced excellent tissue coagulation and necrosis, similar to other laser delivery systems and reports dealing with laser coagulation prostatectomy. CONCLUSIONS: The primary mechanism accounting for therapeutic efficacy of the contact-free beam technique for Nd:YAG laser prostatectomy utilizing the Ultraline delivery system at high-power settings appears to be tissue coagulation with subsequent necrosis and slough, rather than tissue vaporization. This is consistent with the known tissue effects of the Nd:YAG laser wavelength in other systems.

Animals↗
PubMed1994

Spermatic cord metastasis from transitional cell carcinoma of the bladder.

A case of transitional cell carcinoma of the bladder metastasizing to the spermatic cord is reported. This represents the only clinically recognized site of tumor recurrence in a man treated with radical cystoprostatectomy followed by four cycles of adjuvant cis-platinum/methotrexate/vinblastine (CMV) chemotherapy for Stage D1 disease (local pelvic lymph node involvement). The existing literature concerning metastatic tumors of the spermatic cord is reviewed.

Aged↗
PubMed1994

Youssef's syndrome: preservation of uterine function with subsequent successful pregnancy following surgical repair.

We report a 30-year-old female with vesicouterine fistula (Youssef's syndrome). Surgical therapy included transabdominal repair of bladder and uterus with interposition of greater omentum. Uterine function was preserved with subsequent successful pregnancy and delivery of a healthy baby boy by elective Cesarean section at 36 weeks' gestation. The details of the case are discussed and the literature is reviewed regarding fertility and pregnancy after surgical repair.

Adult↗
PubMed1993

Intrascrotal neurofibromas.

A solitary intrascrotal neurofibroma in a seventy-seven-year-old man is reported. This benign tumor of the nerve sheath arises from the Schwann cell and is rare in the external genitalia, especially in the absence of clinical and histopathologic stigmas of von Recklinghausen neurofibromatosis. The literature on intrascrotal neurofibromas is reviewed.

Aged↗
PubMed1993

Large, organ confined, impalpable transition zone prostate cancer: association with metastatic levels of prostate specific antigen.

We present 3 of 25 patients with massive, occult transition zone cancers 7 to 86 cc in volume. Despite serum prostate specific antigen (PSA) levels of 150 to 456 ng./ml. (Yang polyclonal assay), all 3 were organ confined at radical prostatectomy and have undetectable serum PSA levels by an ultrasensitive assay at 300 to 650 days postoperatively. This clinical syndrome includes a highly elevated PSA level, benign prostatic hyperplasia on digital rectal examination, a nondiagnostic transrectal ultrasound and frequently negative transrectal or perineal needle biopsies. Clinical recognition of this syndrome plus systematic biopsies of the transition zone are the keys to diagnosis and potential cure of these patients. These cases may explain the 10% rate of men who present with metastatic prostate cancer and a normal rectal examination, much of the discrepancy between focal cancer on biopsy and large cancers in radical prostatectomy specimens, and why some men have an extraordinarily high serum PSA level and organ-confined cancer at prostatectomy.

Adenocarcinoma↗
PubMed1992

The effect of bacteriuria on bladder and renal pelvic pressures in the rat.

We investigated the effect of urinary tract infection on bladder and renal pelvic urodynamics in a rat model to examine the role of pressure during infection. Either an antibiotic solution (control group) or Escherichia coli with type 1 pili (infected group) was instilled into the bladder. After 2 to 6 days simultaneous continuous bladder and renal pelvic pressures were measured during urinary flows from less than 2 to greater than 20 ml./kg. per hour while the bladder filled and emptied. Bladder pressures from 50 to 100% of maximum capacity and maximum voiding pressures were significantly higher in the infected group than the control group (36.7 +/- 6.79 cm. water versus 25.5 +/- 5.21 cm. water, respectively, p less than 0.0001). Renal pelvic pressures were significantly higher in the infected group during bladder filling at all urinary flows examined and actually exceeded bladder pressure for the highest flows. We conclude that elevated renal pelvic pressures may contribute to renal changes observed during urinary tract infection.

Animals↗
PubMed1992

Ureteral compliance and histology in partial obstruction in a canine model.

Standardized partial ureter obstruction was achieved in 35 mongrel dogs in whom ureteral compliance and its relationship to histologic changes were studied over a period of 26 weeks. The partially obstructed ureter became dilated with thickened wall and showed muscle hypertrophy and connective tissue proliferation. The normal stellate configuration of the ureteral lumen gradually flattened and became entirely circular by the eighth week. The compliance of the obstructed ureter increased gradually after one, 2, 4, and 8 weeks but decreased thereafter at 12 and 26 weeks. At 8 weeks, the ureter was significantly more compliant than both, the unobstructed control ureter (p less than 0.005) and the 12 week and 26 week partially obstructed ureters (p less than 0.005 & p less than 0.05 respectively). The increase in ureteral compliance was proportional to the amount of muscle hypertrophy during the first 8 weeks while the subsequent decrease in compliance (at 12 and 26 weeks) was proportional to the amount of connective tissue proliferation. This study documents ureteral response, both functional and histologic, to partial obstruction in a canine model over 26 week duration.

Animals↗
PubMed1992

Intravesical migration of intrauterine device.

Intrauterine devices have been plagued by many early and late complications, including uterine perforation and migration into adjacent structures. To our knowledge only 18 cases have been reported in the literature of migration of an intrauterine device into the bladder. We report on a 38-year-old woman in whom an intrauterine device eroded from the uterus 3 years after placement. The device remained asymptomatic in the pelvis for an additional 13 years before the patient presented with urinary symptoms. The literature is reviewed.

Adult↗
PubMed1992

Microwave coagulation therapy on VX-2 carcinoma implanted in rabbit urinary bladders.

In order to evaluate the effectiveness of microwave coagulation therapy on urinary bladder carcinoma, we conducted a series of experiments using carcinoma VX-2 cells designed for the application on animal hosts. Three days after implantation of VX-2 cells into the bladder of the rabbits, microwave coagulation therapy was performed. The antitumor effect, i.e. the survival rate, the histological study and the immunological response of the microwave therapy was examined in comparison with the control group (no treatment), the partially cystectomized group and the sham-operated group (no tumor cell implantation). The results were obtained as follows. (1) The survival rate in the microwave group was greater than that in the control group. (2) The stimulation index value (SI), which represents humoral immunity, decreased postoperatively in all groups. In the microwave group, SI increased gradually beginning 21 days after the transient decrease. (3) Histological findings revealed severe degeneration, necrosis and complete eradication of the cancer cells of the bladder wall in the microwave group, however, perforation of the urinary bladder could not be detected. The results indicate that microwave coagulation therapy is an effective procedure for urinary bladder tumors. Furthermore, microwave therapy may also accelerate the inactivation of immunological suppressors in the carcinoma host, an additional benefit of the microwave procedure.

Animals↗
PubMed1991

Familial occurrence of thyroglossal duct cyst.

Persistence and dilation of the embryologic thyroglossal tract gives rise to the condition of thyroglossal duct cyst. Although these cysts have an embryologic origin, there is rarely a history of inheritance. A search of the literature shows only two family reports, which includes a total of nine patients. We report on a third family with thyroglossal duct cyst in two members. The patients were female siblings aged 2 and 6 years, both of whom underwent successful surgical excision of their thyroglossal duct cysts by modified Sistrunk's technique.

Child↗
PubMed1991

Pediatric genitourinary tumors.

Childhood genitourinary tumors are rare and continue to demand collaborative protocols to accumulate adequate numbers of patients for studies, and a multidisciplinary approach for treatment. This paper reviews all the 1990 literature on the most common of these tumors--Wilms' and testicular tumors and rhabdomyosarcoma. The molecular and cellular biology and pathology of Wilms' tumor, as well as treatment advances, are discussed, emphasizing attempts to minimize treatment morbidity and mortality while maintaining optimal quality and quantity of life.

Humans↗
PubMed1991

Prophylactic minitracheotomy in lung resections. A randomized controlled study.

Thirty consecutive patients undergoing lung resections were randomized into two groups: Group A (n = 15) received minitracheotomy postoperatively and group B (n = 15) were control patients. Postoperative respiratory course was monitored by serial clinical assessments, chest x-ray examination, arterial blood gases, sputa bacterial cultures, and the patient's requirement and response to chest physiotherpy. The two groups were similarly matched in age (mean 58.5 years), smoking habits, pulmonary functions, and surgical procedures. Postoperative pulmonary complications of collapse/consolidation developed in 11 patients (two in group A and nine in group B) (p less than 0.03). Four patients (all in group B) required nimitracheotomy in addition to antibiotics and chest physiotherapy to treat their pneumonia. Chest physiotherapy requirement was less in group A than in group B, with a mean number of sessions of seven in group A and eight in group B and a mean total time of 92 minutes in group A and 112 minutes in group B. The mean duration of minitracheotomy was 4.13 days. Minor temporary symptoms resulted from the minitracheotomy in eight patients (42%) and included discomfort, voice changes, subcutaneous emphysema, and stridor. There was one case of long-term morbidity (5%)-skin scarring from wound infection at the site of the minitracheotomy. No postoperative deaths resulted. We conclude that the prophylactic use of minitracheotomy is safe and effective in decreasing postoperative respiratory complications in patients undergoing lung resections.

Adult↗
PubMed1989

A new technique of using the in situ appendix as a catheterizable stoma in continent urinary reservoirs.

A new technique of using the in situ appendix to construct a continent catheterizable stoma is described in a patient who underwent continent urinary diversion, and the technical aspects of this procedure are illustrated in detail. The appendix is remodeled by invaginating its base into the cecum for 1 cm., cecoplicating the middle portion for 2 cm. and bringing the distal end to the skin as a cutaneous stoma. This new technique demonstrates that the in situ appendix can be constructed successfully to provide continence without the need for isolating it from the cecum and implanting the distal end into the urinary reservoir as described in the Mitrofanoff technique.

Adult↗