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Biomedical subjects

M S Ansari

Publications and source records attributed to M S Ansari.

At least 73 records · Page 4Linked to original sources

Cost-reductive retroperitoneal excision of large adrenal pseudocyst: a case report and review of the literature.

We report a case of a non-functioning cystic adrenal mass. It was detected on an abdominal ultrasound carried out for right flank pain in a 45-year-old lady. Biochemical parameters like 24-hour urinary free cortisol, catecholamines and serum potassium level were normal. Retroperitoneoscopic excision of the large cystic mass was done by using our cost-reductive technique as previously described. Histopathology turned out to be a pseudocyst with wall fibrosis and calcification.

Adrenal Gland Diseases↗

Giant pseudoaneurysm of posterior division of renal artery: a rare complication of pyelolithotomy.

Giant renal artery pseudoaneurysm after pyelolithotomy is an uncommon but important disorder. A case of giant pseudoaneurysm arising from the posterior division of right renal artery following pyelolithotomy is presented. The patient presented with a flank mass six months after pyelolithotomy. CT-scan as well as selective renal angiography revealed a giant pseudoaneurysm arising from the posterior division of renal artery. Nephrectomy was necessitated as selective embolization was not possible due to its extraordinarily large size.

Adult↗

Primary small cell neuroendocrine carcinoma of urinary bladder: an uncommon entity to be recognized.

INTRODUCTION: To describe the clinical presentation, diagnosis and treatment outcome of neuroendocrine carcinoma of urinary bladder. METHODS: Clinical and pathological findings of 11 patients with diagnosis of small cell neuroendocrine tumour (SCNE) of urinary bladder are reviewed between Jan. 1991 to Jan 2001. Clinical data including age, sex, presenting symptoms, clinical stage at presentation, modality of treatment and outcome were determined. Sections of the tumour were studied by immunohistochemical methods using various antibodies to determine neuroendocrine pattern. RESULTS: Patient age ranged from 35 to 79 years (mean 60 years). The clinical presentation included, gross hematuria 6, increased urinary frequency and dysuria 3, hydroureteronephrosis with flank pain 2. 3 patients had open exploration for presumed bladder stones by suprapubic route. Undifferentiated carcinoma was the initial report in 2 and associated transitional cell carcinoma in 2 cases. Urinary cytology obtained in 4 patients showed poorly differentiated carcinoma. Immunohistochemistry showed in all cases. 7 patients had radical cystoprostatectomy with adjuvant chemotherapy and 4 patients had combination of chemotherapy and radiotherapy. The survival ranged from 6 months to 30 months (mean 16.5 months). CONCLUSION: Primary small cell neuroendocrine carcinoma of urinary bladder is an aggressive malignancy with poor long-term outcome. Awareness of clinical presentation with free application of immunocytochemistry is emphasized to diagnose this unusual malignancy at earliest.

Adult↗

Cystitis cystica glandularis masquerading as a bladder tumor.

A young man admitted with complaints of painless paroxysmal gross hematuria was found to have bilateral vesical masses involving the bladder base, trigone and ureteric orfices. Urine cytology and AFB were negative. Transurethral resection of the bladder mass was carried out and the histopathology suggested cystitis cystica glandularis. The literature regarding this entity has been reviewed and the differential diagnosis discussed.

Adult↗

Ureteral stent--help or hindrance? In healing of post traumatic nephrocutaneous fistula.

Nephrocutaneous fistulas are rare complications of blunt or penetrating renal trauma. The majority are managed conservatively, some may require percutaneous drainage or ureteral stenting and some require operative intervention. Diversion of the urine by a ureteral stent usually aids in the healing of the fistula. We present an unusual case of nephrocutaneous fistula following blunt renal trauma which persisted as long as a stent was in place but healed immediately after the stent was removed.

Adolescent↗

Mycotic abdominal aortic aneurysm: a fatal sequel to concomitant prostatic and renal aspergillosis. Case report and review of the literature.

We report the first case of aspergillus mycotic aneurysm as a sequel to concomitant prostatic and renal aspergillosis. The patient had undergone left nephrectomy and transurethral resection of prostate for aspergillus infection one year ago. He again presented with LUTS and backache and clinical examination showed visible pulsations in the epigastrium. CT-scan abdomen showed a pseudoaneurysm of the abdominal aorta. The aneurysm was repaired in situ with homografting and omental wrap. However, the patient succumbed to septicemia on the tenth postoperative day. Adjunctive surgery is usually essential as medical management alone has been unsatisfactory. It is imperative that these cases should be followed closely to detect the disease recurrence and complications at the earliest.

Aged↗

Primary squamous cell carcinoma of the prostate: a rare clinicopathological entity. Report of 2 cases and review of literature.

Primary squamous cell carcinoma of the prostate is an uncommon clinicopathological entity. It differs from more common adenocarcinomas in its cell of origin, biological behavior, therapeutic response to the usual hormonal manipulation and prognosis. The review shows that squamous cell carcinoma is biologically more aggressive than adenocarcinoma. Despite the agreement on its uniqueness, a controversy exists on the exact histopathogenesis, diagnostic criteria and modality of treatment. We report on 2 patients with primary squamous cell carcinoma of the prostate. One patient presented with lower urinary tract symptoms with a hard nodular prostate on digital rectal examination, and the other with acute urinary retention on normal digital rectal examination. The evaluation revealed metastasis in the pelvic and right femur in both cases. Palliative transurethral resection of the prostate with chemotherapy (Adriamycin based) was given in both the cases. However, both the patients died at 4 and 5 months of follow-up, respectively.

Aged↗

Marjolin's ulcer of the suprapubic cystostomy site infiltrating the urinary bladder: a rare occurrence.

We report a case of a 40-year-old man who had presented with a spontaneous suprapubic urinary leak from a well-healed suprapubic cystostomy tract scar, 20 years following a successful scrotal tube substitution urethroplasty done for a post-traumatic urethral stricture. Preoperative contrast studies suggested a recurrent bulbomembranous urethral stricture. Excision biopsy of the suprapubic fistulous tract revealed scar cancer infiltrating the bladder wall. Of 3 similar cases reported in the past, only 1 had bladder involvement. Ours is the second such case with bladder involvement.

Adult↗

Diagnosis and management of post-cesarean ureterouterine fistulae.

Urinary leakage following obstetric or gynecologic surgery is a dreaded complication, most often caused by a urogenital fistula. Of these, uretero-uterine fistulae are relatively rare and pose a diagnostic and therapeutic dilemma. A 29-year-old woman presented with paradoxical incontinence of urine for 3 months. She had developed vaginal leakage of urine 2 weeks following an uneventful cesarean section. Conservative measures in the form of catheterization and bed rest did not relieve her symptoms. Subsequent examination and investigations revealed that she had a ureterouterine fistula. The case is discussed as well as the diagnostic modalities and treatment options.

Adult↗

Diastereotopy in some 3,4-dihydroisocoumarins--effect of changing the substituents on the chiral centre.

Diastereotopy has been investigated in eight different derivatives of 3,4-dihydroisocoumarins by changing the substituent on the pyran ring chiral centre, C-3. A diastereotopic NMR effect is observed for the prochiral methylene protons on the benzopyran ring and the effect is greatly influenced by the pi-electron system of the substituent. The effect is also observed for the substituents, however, the extent of diastereotopy depends upon their nature and the separation of methylene groups from the chiral centre.

Coumarins↗

Patency of different arterial and venous end-to-side microanastomosis techniques in a rat model.

Microvascular anastomotic patency is the most important factor in determining a successful outcome in free-flap transfers. End-to-end and end-to-side techniques have been shown to provide equivalent arterial patency rates in clinical and basic science studies, and end-to-side anastomoses have been used extensively in microsurgical reconstruction. Nevertheless, the effect of venotomy shape on the patency of venous end-to-side anastomoses has not been previously reported. The purpose of this study was to compare the patency rates of end-to-side anastomoses using different techniques in both arteries and veins. In total, 104 Sprague-Dawley rats were subdivided into four groups. The rats were anesthetized, and anastomosis was performed on either the femoral artery or vein on the right with the left used as control. Vesselotomy was varied between an end-to-side hole and an end-to-side slit with patency measured immediately following surgery and at 2 weeks. No significant difference in patency or histology between these techniques was demonstrated in any group. We conclude there is no difference in patency rate between the two techniques in arterial or venous vesselotomies; however, in small vessels < 1.5 mm, the slit technique is technically easier, and clinical recommendations are given.

Anastomosis, Surgical↗

Open thumb forceps. An unusual foreign body in the urethra: technique of its removal.

A great variety of foreign bodies in the urethra have been reported in the literature. Mostly, these cases were reported to emphasize the unusual nature of the objects requiring technical modifications for their removal. We report an interesting case of self introduced open thumb forceps into the urethra and technique of its retrieval.

Adult↗

Spontaneous perirenal hematoma. A case report and review of literature.

Spontaneous perirenal hematoma (SPH) is a clinical entity that poses a diagnostic and therapeutic challenge. We report a case of SPH in an adult where the cause could not be determined at first presentation, even with computed tomography (CT) of the abdomen and angiography. He was under close follow-up, and it was only with a repeat CT scan after 3 months that a mass lesion in the kidney was identified as the underlying cause. We also present a review of the literature so that a logical approach can be adopted for this problem.

Hematoma↗

Characterization of (S)-des-4-amino-3-[125I]iodozacopride ([125I]DAIZAC), a selective high-affinity radioligand for 5-hydroxytryptamine3 receptors.

The 5-hydroxytryptamine(HT)3 receptor subtype is present in the central nervous system (CNS) in low abundance, and few selective radiolabeled antagonists with high specific activity are available to study these sites. DAIZAC [desamino-3-iodo-(S)-zacopride; (S)-5-chloro-3-iodo-2-methoxy-N-(1-azobicyclo-[2.2. 2]oct-3-yl)benzamide] is a compound with high affinity and selectivity for the 5-HT3 receptor. Scatchard analysis of specific binding to NCB-20 cell membranes gave a Bmax of 340 +/- 58 fmol/mg protein and a KD of 0.14 +/- 0.03 nM, which is in agreement with the value previously reported in rat brain (KD = 0.15 nM). Nonspecific binding of [125I]DAIZAC in NCB-20 cells was <1% of total binding at the KD for DAIZAC compared with 17% in the rat brain preparation. Unlabeled DAIZAC (10 microM) showed minimal ability to displace binding of radiolabeled ligands selected for their affinities for other CNS receptor and uptake carrier binding sites. The discrimination ratio of DAIZAC for the 5-HT3 receptor over the M1 muscarinic binding site, the non-5-HT3 site at which it was most potent, was >2800. Serotonergic antagonists at every other known CNS serotonergic binding sites (3-30 microM) were ineffective in displacing [125I]DAIZAC binding in rat brain membranes. Similarly, antagonists (3-30 microM) for other nonserotonergic receptors and uptake sites were ineffective in displacing [125I]DAIZAC binding. Autoradiographic studies showed highest specific binding in area postrema and nucleus solitarius, with intermediate levels of binding in entorhinal cortex and hippocampus. DAIZAC inhibited 5-HT3 receptor-mediated inward cation current in NCB-20 cells with an IC50 of 0.24 nM. [125I]DAIZAC is a potent and highly selective ligand for in vitro studies of the 5-HT3 receptor.

Animals↗

Dosimetry of iodine-123-epidepride: a dopamine D2 receptor ligand.

UNLABELLED: Substituted benzamides have been shown to have very high affinity and specificity for the dopamine D2 receptor. One of these is radiolabeled epidepride, an iodine-substituted benzamide currently under evaluation as a SPECT imaging agent. Detailed estimates of the radiation absorbed dose to 26 organs and the whole body from [123I]epidepride have been calculated. METHODS: The dosimetry calculations use a combination of in vivo uptake and biodistribution data from one rhesus monkey and seven humans to estimate residence times in eight organs. The computer program MIRDOSE2 was used to calculate the dosimetry. RESULTS: Results indicate that 75% of the radioactivity is cleared through the urinary tract while the remaining radioactivity clears through the gallbladder and intestinal tract. The radiation absorbed dose can be minimized by administering a high lipid content meal 1.5 hr postinjection to empty the gallbladder and by giving large volumes of fluids throughout the study to induce increased urinary output. CONCLUSION: By emptying the gallbladder and urinary bladder, the lower large intestine becomes the critical organ, 0.102 mGy/MBq (0.38 rad/mCi) followed by the upper large intestine, 0.092 mGy/MBq (0.34 rad/mCi). The effective dose equivalent is 0.025 mSv/MBq (0.092 rem/mCi).

Animals↗

Identification of extrastriatal dopamine D2 receptors in post mortem human brain with [125I]epidepride.

The regional distribution of striatal and extrastriatal dopamine D2 receptors in human brain was studied in vitro with (S)-N-[(1-ethyl-2- pyrrolidinyl)methyl]-5-[125I]iodo-2,3-dimethoxybenzamide, [125I]epidepride, using post mortem brain specimens from six subjects. Scatchard analysis of the saturation equilibrium binding in twenty-three regions of post mortem brain revealed highest levels of binding in the caudate (16.5 pmol/g tissue) and putamen (16.6 pmol/g tissue) with lower levels seen in the globus pallidus (7.0 pmol/g tissue), nucleus accumbens (7.2 pmol/g tissue), hypothalamus (1.8 pmol/g tissue), pituitary (1.3 pmol/g tissue), substantia innominata (1.0 pmol/g tissue), and amygdala (0.87 pmol/g tissue). Of note was the presence of dopamine D2 receptors in the four thalamic nuclei studied, i.e. anterior nucleus (1.0 pmol/g tissue), dorsomedial nucleus (0.96 pmol/g tissue), ventral nuclei (0.72 pmol/g tissue), and pulvinar (0.86 pmol/g tissue), at levels comparable to the amygdala (0.87 pmol/g tissue) and considerably higher than levels seen in anterior cingulate (0.26 pmol/g tissue) or anterior hippocampus (0.36 pmol/g tissue). The frontal cortex had very low levels of dopamine D2 receptors (0.17-0.20 pmol/g tissue) while the inferior and medial temporal cortex had relatively higher levels (0.31-0.46 pmol/g tissue). Inhibition of [125I]epidepride binding by a variety of neurotransmitter ligands to striatal, ventral thalamic and inferior temporal cortical homogenates demonstrated that [125I]epidepride binding was potently inhibited only by dopamine D2 ligands. The present study demonstrates that dopamine D2 receptors are present in basal ganglia, many limbic regions, cortex and in the thalamus. The density of thalamic D2 receptors is comparable to many limbic regions and is considerably higher than in cortex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗