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Biomedical subjects

M Susani

Publications and source records attributed to M Susani.

At least 91 records · Page 5Linked to original sources
PubMed1994

Tissue ablation in benign prostatic hyperplasia with high intensity focused ultrasound.

In a phase I clinical trial the morphological impact and safety of high intensity focused ultrasound administered transrectally for tissue ablation in prostates from 22 patients undergoing subsequent prostatectomy were evaluated. Location and size of the tissue lesions correlated well with the predefined target area and revealed sharply delineated coagulative necrosis in all cases. Intervening tissues, such as the rectal wall and posterior prostate capsule, were invariably intact. In a subsequent phase II clinical trial the effectiveness of transrectal high intensity focused ultrasound as a novel minimally invasive treatment modality for 50 patients with symptomatic benign prostatic hyperplasia was determined. The maximum urinary flow rate (ml. per second) increased from 8.9 +/- 4.1 to 12.7 +/- 6.4 at 3 months in 44 patients, 12.4 +/- 5.6 at 6 months in 33 and 13.1 +/- 6.5 at 12 months in 20. During the same period the post-void residual volume (ml) decreased from 131 +/- 120 to 48 +/- 41, 59 +/- 42 and 35 +/- 30, respectively, and the American Urological Association symptom score (points) decreased from 24.5 +/- 4.7 to 13.3 +/- 4.4, 13.4 +/- 4.7 and 10.8 +/- 2.5, respectively. These data demonstrate that transrectal high intensity focused ultrasound is capable of inducing coagulative necrosis in the human prostate via a transrectal approach while preserving intervening and adjacent tissue. A 47% (+4.2 ml. per second) improvement in uroflowmetry and a 53% (-13.7 points) decrease in the American Urological Association symptom score 1 year after treatment clearly prove that transrectal high intensity focused ultrasound is a novel and safe minimally invasive treatment option for benign prostatic hyperplasia.

Aged↗
PubMed1994

[Experimental laser surgery of the ossified cochlea].

A pulsed holmium: YAG-laser (lambda = 2120 nm) was used to reopen the basal turn of artificially obliterated human cochleas in freshly dissected cadavers for intracochlear insertion of the stimulation electrode of a cochlear implant under simulated surgical conditions. Laser energy was transmitted through a 400 microns nylon fibre via the opened facial recess directly to the round window niche. At an energy level of 500 mJ/2.5 microseconds pulse, a repetition rate of 2 Hz, and an exposure time of 20-30 s, the photo-ablative mechanism of laser-bone interaction, which has only a limited thermal component, led to recanalisation of the basal turn of the cochlea in a length of 8-10 mm without damaging the surrounding structures. Light microscopic changes in the cochlea were evaluated following laser recanalisation. The artificial bony occlusion and the recanalised basal turn of the cochlea were visualised by means of computed tomography and histological thin section technique.

Cochlea↗
PubMed1994

Revised analysis of aadA2 gene of plasmid pSa.

The nucleotide sequence of gene aadA2 of plasmid pSa, coding for aminoglycoside-3"-adenyltransferase, has been reexamined. We found differences with respect to the sequence previously determined by Tait et al. (R. C. Tait, H. Rempel, R. L. Rodriguez, and C. I. Kado, Gene 36:97-104, 1985). These deviations are located in the coding region and in the 3' noncoding region. By making deletions in the region for initiation of protein synthesis, we identified a GTG triplet as the most probable start codon for translation.

Amino Acid Sequence↗
PubMed1994

Prostatic metastasis of a small cell lung cancer in a young male.

The case of a 23-year-old male with a solitary prostatic metastasis of a small cell lung cancer is reported. After diagnosis was established by ultrasound-guided transrectal biopsies and bronchial lavage, the patient received 7 cycles of polychemotherapy according to the AEO protocol. While the pulmonary tumour responded with a dramatic remission, the size of the prostatic metastasis remained unchanged. Subsequent radiotherapy to the prostate and pelvis (59 Gy) did not result in tumour reduction. Shortly thereafter, the patient developed polytopic metastases and died 16 months after diagnosis. Even in a young male, the presence of a prostatic metastasis should be considered as a potential diagnosis if prostate biopsies are positive for a small cell carcinoma.

Adult↗
PubMed1994

Effects of nimodipine on regional blood flow in heart and brain during cardiopulmonary resuscitation in pigs.

The effect of nimodipine on organ blood flow during cardiopulmonary resuscitation (CPR) was studied in 26 anesthetized pigs. After 5 min of ventricular fibrillation circulatory arrest and 5 min of external CPR, all animals received 50 micrograms/kg of epinephrine and either nimodipine (10 micrograms/kg, followed by 1 microgram.kg-1.min-1 until termination of the experiment) or placebo. Organ blood flow was measured using radioactive-labeled microspheres. The rate of resuscitability in nimodipine-treated pigs (11 of 12) was significantly higher (P < 0.05) than in placebo-treated animals (7 of 14). In pigs receiving epinephrine and nimodipine, left ventricular blood flow after restoration of spontaneous circulation (ROSC) was approximately twice as high as in pigs receiving epinephrine and placebo (P < 0.01). In nimodipine-treated pigs, total cerebral blood flow 10 min after ROSC was significantly higher than baseline values (P < 0.01) and in hypophysis, cerebellum, and medulla the blood flows were significantly higher than in placebo-treated pigs (P < 0.05). We conclude that, in our pig model, high doses of nimodipine given during CPR caused significant enhancements in left ventricular blood flow and significantly improved the rate of resuscitation.

Animals↗
PubMed1994

Antibodies to glycolipids activate complement and promote proteinuria in passive Heymann nephritis.

Passive Heymann nephritis is an experimental rat model of human membranous nephropathy induced by injection of antisera against crude renal cortical fractions such as Fx1A or rat tubular microvilli. This results in the formation of subepithelial immune deposits, the activation of the C5b-9 membrane attack complex of complement, and severe proteinuria. While the formation of immune deposits is attributed to in situ immune complex formation with antibodies specific for the gp330-Heymann nephritis antigenic complex (HNAC), activation of complement and proteinuria appear to be caused by at least one additional antibody species present in anti-Fx1A sera. We have separated by affinity absorption polyspecific antisera against Fx1A and rat microvilli into one IgG fraction directed specifically against microvillar proteins (anti-Fx1A-prot) and another IgG fraction specific for glycolipids (ant-Fx1A-lip) of tubular microvilli. When injected into rats, the anti-Fx1A-prot fraction induced immune deposits but failed to activate complement or produce proteinuria, similar to results obtained with affinity-purified anti-gp330 IgG. When the antibodies of the anti-Fx1A-lip fraction were injected alone they did not bind to glomeruli. By contrast, when the IgGs specific for the Fx1A-prot fraction (or for gp330-HNAC) were combined with those directed against the Fx1A-lip glycolipid preparation, immune deposits were formed, in situ complement activation was observed, and also proteinuria was induced. It is concluded that within anti-Fx1A and anti-microvillar sera there are at least two IgG fractions of relevance for the development of PHN: one directed against the gp330-HNAC complex which is responsible for the development of immune deposits, and a second specific for glycolipid antigen(s) which activate(s) the complement cascade.

Animals↗
PubMed1993

Infrared laser soft tissue ablation versus ultraviolet excimer laser. Experimental introduction of the Hol:YAG-laser in oral surgery.

The in vivo tissue ablation characteristics of a pulsed infrared laser (Hol:YAG, lambda = 2120 nm) and a pulsed excimer laser (XeCl, lambda = 308 nm) were studied in an animal model. Laser energy was delivered via nylon fibers for the Hol:YAG laser and via quartz fibers for the excimer laser. Laser incisions were made under precise reproducible conditions on the sublingual side of the tongue and the gingiva of white rats. Laser surgery was done at two different energy output settings for the Hol:YAG laser and at one setting for the excimer laser. Histologic studies revealed tissue defects with clean contours for both laser types with small zones of necrosis of the adjacent tissue (Hol:YAG: 180 microns to 640 microns; excimer: 40 microns to 160 microns) and without carbonization. Both laser types function on the principal of photoablation and permit excellent control of tissue ablation. Wound healing was studied over a 10-day period and showed complete wound closure by re-epithelialization. The in vivo tissue ablation characteristics and the surgical reliability of the two lasers are compared and discussed with respect to oral and periodontal surgery.

Animals↗
PubMed1993

[Holmium:YAG laser surgery of nasopharyngeal cancer].

A pulsed Holmium:YAG-laser (lambda = 2,120 nm) was used for the first time clinically in tumour surgery. The primary lesion of a transitional cell carcinoma of the nasopharynx with metastatic disease in the neck (T2N2Mo) was laser resected in a photoablative manner with a minor thermal component without danger of damage to the skull base. Neck dissection was performed by conventional surgery. In comparison to laser types depending primarily on the thermal effects of laser-tissue interaction the coagulative necrosis zone following Holmium:YAG-laser surgery is small and there is no area of carbonisation. Macroscopic wound healing showed no complications and was completed after three weeks. At this time radiation therapy was started. The results of the histological examination and the physical properties of this new infrared laser system are discussed as well as the possibilities of flexible fiber Holmium:YAG endoscopic laser tumour surgery in clinical use.

Carcinoma, Transitional Cell↗
PubMed1993

[Plasmacytoma of the nose and paranasal sinuses with intracranial and orbital extension].

A rare case of a solitary extramedullary plasmocytoma of the nasal cavity and the paranasal sinuses with orbital and intracranial extension of a 61-year old male patient was examined clinically, histologically and immunohistologically. The interrelationship of the generalised disease (multiple myeloma = MM) and the solitary extramedullary form (extramedullary plasmocytoma = EMP) is discussed as well as the importance of the magnetic resonance imaging in the diagnosis of tumours of the facial part of the skull.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Morphology of tissue destruction induced by focused ultrasound.

The effect of high-intensity focused ultrasound (HIFU) ablation on the morphology of prostatic, renal and testicular tissue was studied by light and electron microscopy. Specimens were obtained in 21 patients 1 h to 10 weeks after lesioning. Histological findings showed consistent coagulative necrosis with precisely defined, sharp margins to normal tissue. Lesion size and position correlated well with the assumed target zones, suggesting that HIFU permits therapeutic tissue ablation.

Humans↗
PubMed1993

Tissue ablation in benign prostatic hyperplasia with high-intensity focused ultrasound.

The safety and effectiveness of tissue ablation by coagulative necrosis with high-intensity focused ultrasound (HIFU) applied through a rectal probe to 36 patients with symptomatic benign prostatic hyperplasia (BPH) was investigated in a phase II clinical trial. Overall, HIFU treatment was well tolerated, the mean hospital stay being 1.1 days. Negative side effects were transient urinary retention in 32/36 patients, hematuria in 2 patients and hematospermia resolving after 3-4 weeks (n = 15). After 3 months the maximum flow rate/s (Qmax) increased from 9.0 +/- 3.9 to 14.4 +/- 7.0 ml/s, the median flow rate/s (QM90) from 4.9 +/- 2.4 to 7.6 +/- 4.17 ml/s; the postvoid residual volume decreased from 128 +/- 88 to 57 +/- 35 ml and the AUA symptom score from 25.5 +/- 5 to 13.2 +/- 4.4. In conclusion, it was shown that tissue ablation in patients with symptomatic BPH using HIFU is safe and dramatically reduces both obstructive and irritative symptoms and leads to a significant increase in uroflow and a decrease in postvoid residual volume.

Feasibility Studies↗
PubMed1992

[Holmium:YAG and erbium:YAG infrared laser osteotomy].

The in-vivo bone ablation characteristics of a pulsed solid-state erbium:YAG laser were compared to those of a pulsed solid-state holmium:YAG laser. Partial osteotomies in the maxillary, the mandibulary, and the nasal bones of white rats were performed. The tissue response was examined by light microscopy. Thermal gradients following the laser application were also measured. Over all energy levels tested the erbium:YAG laser produced ablation of bone with minimal thermal damage to the adjacent tissue. The results of this study are promising for future application of the infrared holmium- and erbium:YAG lasers in otorhinolaryngology.

Animals↗
PubMed1992

Incidence of testicular microlithiasis.

In adults polytopic intratubular calcifications of the testes are rare. Known as testicular microlithiasis, they manifest themselves in a characteristic echo pattern on sonography with high-frequency transducers (5 to 10 MHz). This consists of multiple echogenic specks in an otherwise normal testicular parenchyma. In a retrospective analysis of 1,710 testicular sonograms of adults, bilateral intratesticular microliths were found in 11 cases (0.6%). In 5 of them, the microliths were associated with a testicular tumor. One patient with a tumor in the contralateral testis had undergone radiotherapy and another one presented with hypogonadism. Four patients with noncontributory histories presented with varicocele or epididymal cyst. Sonographic findings were confirmed histologically in 6 patients. Multiple intratubular calcifications were found in all of them. The pathogenesis of testicular microliths is still poorly understood. Their clinical relevance is unclear, but their incidence in adults appears to be higher than reported in the literature.

Adult↗
PubMed1992

[Holmium:YAG infrared laser and UV-Excimer. Laser effects on oral mucosa].

The in-vivo tissue ablation characteristics of a pulsed infrared laser (Holmium:YAG, lambda = 1980) and a pulsed excimer laser (XeCl, lambda = 308 nm) were studied. The holmium laser energy was coupled into nylon fibres. The excimer laser energy was coupled into quartz fibers. Laser incisions were made on white rats at different sites of the tongue. Power settings of 400 mJ per 2.5 microseconds pulse at 5 pulses per second for the holmium:YAG laser and 250 mJ per 1 microsecond pulse at 20 pulses per second for the excimer laser were used. Thermal gradients following laser application were measured. Excellent control of depth of tissue ablation was noted for both types of lasers. The tissue response was examined by light microscopy. Histological studies revealed tissue defects with clean contours. The coagulative necrosis zone for the 400 mJ holmium:YAG injuries measured from 370 microns to 640 microns, compared with 40 microns to 160 microns with the 250 mJ UV-excimer injuries. Wound healing was studied over a six-week period. Histologically, wound closure was completed after four weeks showing re-epithelialization without scar formation for both types of laser. The in-vivo tissue ablation characteristics and the operation reliability of the two lasers were compared.

Animals↗
PubMed1992

Infrared laser tissue ablation: holmium:YAG laser surgery.

The in vivo tissue ablation characteristics of a pulsed holmium:YAG laser (lambda = 1,980 nm) were studied. The laser energy was coupled onto nylon fibers 400 and 600 microns in core diameter. Laser incisions were made on white rats at different sites of the tongue and of the mucous membranes of the oral cavity. Power settings of 500 and 1,000 mJ/2.5-ms pulse at 5 pulses/s were used and the tissue responses examined by light microscopy. Wound healing was studied over a 6-week period. The results of this study are promising for future application of the holmium:YAG laser in otorhinolaryngology.

Animals↗
PubMed1992

Color Doppler imaging of inferior vena cava: identification of tumor thrombus.

Color-coded Doppler sonography (CCDS) was used for the examination of tumor thrombus (n = 7) and benign thrombosis (n = 6) of the inferior vena cava. Tumor thrombus was due to hepatocellular carcinoma in two cases and to renal cell carcinoma in five cases. Whereas no specific information about the nature of thrombus formation could be gained by gray scale sonography, a typical patchy vascularization pattern was noted within tumor thrombi in six of seven cases using CCDS. This ws due to marked neovascularization within the tumor thrombi, confirmed by histologic examination in all cases. In one patient no vascularization within the tumor thrombus could be observed by CCDS because the thrombus was relatively small. In patients with bland thrombosis, either no vascularization of the thrombus was seen (n = 5) or linear recanalization of the thrombus occurred (n = 1). Therefore, it might be possible to differentiate tumor from nontumor thrombus in the inferior vena cava by using CCDS. Further studies are needed to confirm this preliminary hypothesis.

Adult↗
PubMed1992

[Holmium:YAG laser surgery. Possibilities for use in inflammatory paranasal sinus diseases].

A pulsed Holmium: YAG laser (lambda = 2120 nm) was used during functional endoscopic endonasal surgery in ten patients with recurrent chronic inflammation of the paranasal sinuses. The Holmium: YAG laser energy was coupled to a 600 microns core diameter nylon fiber. Power settings of 950 mJ per 2.5 microseconds pulse at 5 pulses per second were used. Tissue responses to treatment were examined by light microscopy. The photoablative mechanism of the laser-tissue interaction led to bone and soft tissue ablation with only a minor thermal component in the target zone. In comparison with other laser types available clinically, there was no carbonization zone after use of the Holmium-YAG laser. The area of tissue damage produced was significantly smaller (370-520 microns only) and wound healing proceeded without complication. The physical settings of the laser equipment are described with regard to their significance in photoablation when using flexible light-conducting fibers. The possible role of the Holmium: YAG laser in clinical surgery is discussed on the basis of the present experience.

Adult↗