8 results on '"el Malt O"'
Search Results
2. Recurrence of hepatitis C virus (genotype 4) infection after living-donor liver transplant in Egyptian patients.
- Author
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Yosry A, Abdel-Rahman M, Esmat G, El-Serafy M, Omar A, Doss W, Zayed N, Said M, Ismail T, Hosny A, Marawan E, El-Malt O, Kamel RR, Hatata Y, El-Taweel A, Ghali A, Sabri H, Kamel S, and El-Gabaly H
- Subjects
- Adult, Biopsy, Carcinoma, Hepatocellular ethnology, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular virology, Egypt epidemiology, Female, Genotype, Hepacivirus immunology, Hepatitis B Antibodies blood, Hepatitis B Core Antigens immunology, Hepatitis C diagnosis, Hepatitis C ethnology, Humans, Liver Cirrhosis ethnology, Liver Cirrhosis pathology, Liver Cirrhosis virology, Liver Neoplasms ethnology, Liver Neoplasms pathology, Liver Neoplasms virology, Living Donors, Male, Middle Aged, Prospective Studies, RNA, Viral blood, Recurrence, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Viral Load, Virus Replication, Black People statistics & numerical data, Carcinoma, Hepatocellular surgery, Hepacivirus genetics, Hepatitis C complications, Liver Cirrhosis surgery, Liver Neoplasms surgery, Liver Transplantation ethnology
- Abstract
Objectives: The recurrence of hepatitis C virus infection after liver transplant is common and may endanger both graft and patient survival. We investigated the frequency and outcome of and risk factors for the recurrence of that virus after living-donor liver transplant in hepatitis C virus positive recipients., Materials and Methods: Seventy-four adult hepatitis C virus positive subjects were monitored for 36 months after living-donor liver transplant and demographic and laboratory data for the recipients and donors were evaluated. Recurrent hepatitis C virus infection was diagnosed on the basis of viral replication revealed by polymerase chain reaction after transplant, elevated levels of transaminases, and the results of liver biopsy., Results: Hepatitis C virus recurrence was identified in 31.1% of the patients studied. Histopathologic recurrence was mild, and 91% of the subjects had a fibrosis score of < or = F2. No recipient exhibited cirrhosis or clinical decompensation during followup. Recurrent hepatitis C virus infection was associated with pretransplant and posttransplant viral load and antibody positive to hepatitis B core antigen. No other risk factors (sex, donor or recipient age, pretransplant Child-Pugh or Model for End-Stage Liver Disease scores, immunosuppressive drug therapy, and treatment with pulse steroids) were significantly correlated with the frequency of hepatitis C virus recurrence, the grade of the histologic activity index, or the stage of fibrosis., Conclusions: In living-donor liver transplant recipients, patient and graft survival rates associated with hepatitis C virus (genotype 4) related cirrhosis were comparable to those in deceased-donor liver transplant recipients reported in the literature. Recurrent infection with hepatitic C virus after living-donor liver transplant was mild. After transplant, a higher viral load and the presence of antibody to hepatitis B core antigen could be risk factors for hepatitis C virus recurrence. Long-term follow-up in a large number of patients is required.
- Published
- 2009
3. Crucial issues of hepatic artery reconstruction in living donor liver transplantation: our experience with 133 cases at Dar El-Fouad Hospital, Egypt.
- Author
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Amin AA, Kamel R, Hatata Y, Attia H, Marawan I, Hosney A, El-Malt O, and Tanaka K
- Subjects
- Adult, Biliary Atresia surgery, Egypt, Female, Hepatic Artery diagnostic imaging, Hepatitis C surgery, Humans, Living Donors, Male, Microsurgery, Middle Aged, Plastic Surgery Procedures, Retrospective Studies, Thrombosis prevention & control, Ultrasonography, Doppler, Hepatic Artery surgery, Liver Transplantation adverse effects, Liver Transplantation methods
- Abstract
Hepatic artery (HA) reconstruction is a crucial step in living donor liver transplantation (LDLT). However, many important aspects specific to this challenging step are still inadequately documented. From August 2001 through March 2007, we performed a total of 133 cases of LDLT at Dar El-Fouad Hospital. The magnifying loupe was used for performing microanastomoses in the first 31 cases, and the operating microscope was used for 98 cases. There were 128 adult and five pediatric patients. One hundred twenty-five patients received right lobe grafts, and seven patients received left lobe grafts. One patient died intraoperatively and was excluded from analysis. Arterial complications occurred in four patients of the first group (4/30, 13%) in the form of early thrombosis. One patient underwent successful interventional thromboembolectomy, two patients underwent surgical reexploration with revision of anastomoses; these three patients survived. The fourth patient died from fulminant liver failure. Regarding the second group, all arterial anastomoses were patent after reconstruction. Signal problems occurred in the form of intraoperative intermittent flow and postoperative no diastole phenomenon. Our overall arterial complication rate was 4.5%; however, we lost only one patient due to HA thrombosis (0.8%). Microsurgical reconstruction of the HA carries its own challenges. The use of operating microscope reduces the risk of complications, and aggressive interference including salvage surgery maximizes the success of HA reconstruction.
- Published
- 2009
- Full Text
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4. Primary chemotherapy with low-dose prolonged infusion gemcitabine and cisplatin in patients with bladder cancer: a Phase II trial.
- Author
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Khaled H, Emara ME, Gaafar RM, Mansour O, Abdel Warith A, Zaghloul MS, and El Malt O
- Subjects
- Adult, Aged, Deoxycytidine administration & dosage, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Gemcitabine, Antineoplastic Agents administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Cisplatin administration & dosage, Deoxycytidine analogs & derivatives, Urinary Bladder Neoplasms drug therapy
- Abstract
Background: Gemcitabine is an active agent in the treatment of bladder cancer. The enzyme deoxycytidine kinase catalyzes the phosphorylation of gemcitabine into the active gemcitabine triphosphate. After an infusion during 30 minutes, this enzyme will be saturated, therefore, accumulation of higher intracellular concentrations of the active gemcitabine triphosphate could be achieved by prolonging the infusion time of gemcitabine., Patients and Methods: Based on previously published Phase I trials, the efficacy and safety of a combination of cisplatin and gemcitabine given as prolonged infusion were tried in a Phase II study of 57 untreated patients with stage III/IV bladder cancer, which is the most common malignant tumor among Egyptian males. Patients received gemcitabine (250 mg/m(2) during 6-hour infusion) on days 1 and 8, and cisplatin (70 mg/m(2)) on day 2 every 21-day cycle., Results: The 41 males and 16 females had a median age of 55 years (range 37-77). A total of 37 patients had transitional cell, 15 had squamous cell, 2 had adenocarcinoma, and 3 had undifferentiated cell carcinoma. The median number of cycles given to these 57 patients was 4 (range 1-6). Of 54 evaluable patients, 5 (9.4%) had complete remission, and 27 (50%) partial remission, for an overall response rate of 59.4%. These results are comparable to those of a previous Phase II study of the same combination but with gemcitabine given in the standard dose and schedule. Responses were observed at all disease sites. Both hematologic and nonhematologic toxicity were treatable and not severe., Conclusions: Prolonged infusion of gemcitabine and cisplatin is an effective treatment for advanced bilharzial-related bladder cancer. Toxicity, especially myelosuppression, is surprisingly mild. This combination deserves to be tried in other different disease categories.
- Published
- 2008
- Full Text
- View/download PDF
5. Detection of telomerase in urine by 3 methods: evaluation of diagnostic accuracy for bladder cancer.
- Author
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Eissa S, Swellam M, Ali-Labib R, Mansour A, El-Malt O, and Tash FM
- Subjects
- Adult, Aged, Humans, Middle Aged, Nucleic Acid Amplification Techniques, RNA urine, Reverse Transcriptase Polymerase Chain Reaction, Sensitivity and Specificity, Urinary Bladder Neoplasms urine, Biomarkers, Tumor urine, Telomerase urine, Urinary Bladder Neoplasms diagnosis
- Abstract
Purpose: New, noninvasive methods are needed for the diagnosis, followup and screening of patients with bladder cancer. Three methods of detecting telomerase were evaluated in this aspect., Materials and Methods: This study included 200 patients diagnosed with bladder carcinoma, 85 with benign bladder lesions and 30 healthy individuals who served as the control group. All underwent serological schistosomiasis antibody assay in serum, urine cytology and estimation of relative telomerase activity by telomeric repeat amplification protocol, human telomerase RNA by reverse transcriptase-polymerase chain reaction and human telomerase reverse transcriptase by real-time reverse transcriptase-polymerase chain reaction in urothelial cells from voided urine., Results: The concordance between the positive rates of telomerase detected by the 3 methods was high (90% to 95%). Results were significantly higher in the malignant group than in the benign and control groups. There was a significant difference among the results of the 3 methods in relation to different clinicopathological factors. Overall the sensitivity of human telomerase reverse transcriptase for detecting bladder cancer was the highest compared to that of human telomerase RNA, relative telomerase activity and urine cytology (96%, 92%, 75% and 75%, respectively). Combinations of telomerase results with urine cytology were not useful except in cases of relative telomerase activity., Conclusions: Detection of human telomerase reverse transcriptase in urine by real-time polymerase chain reaction, followed by human telomerase RNA by reverse transcriptase-polymerase chain reaction, improves sensitivity and specificity for the diagnosis of bladder cancer. However, regarding cost-effectiveness, human telomerase RNA is superior.
- Published
- 2007
- Full Text
- View/download PDF
6. Reconstruction after resection of tumors around the knee: role of the free vascularized fibular graft.
- Author
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Amr SM, El-Mofty AO, Amin SN, Morsy AM, El-Malt OM, and Abdel-Aal HA
- Subjects
- Adolescent, Adult, Bone Neoplasms pathology, Child, Female, Femoral Neoplasms pathology, Health Status Indicators, Humans, Knee, Lung Neoplasms secondary, Male, Postoperative Complications, Quality of Life, Retrospective Studies, Surgical Flaps, Treatment Outcome, Bone Neoplasms surgery, Femoral Neoplasms surgery, Fibula transplantation, Osteosarcoma surgery, Plastic Surgery Procedures, Tibia
- Abstract
We present our experience with reconstruction after resection of tumors around the knee, using free vascularized fibular grafting. The study included 23 patients. The lower femur was involved in 17 cases, the upper tibia in 6. The cases included giant cell tumor of the lower femur (2 patients), giant cell tumor of the upper tibia (1 patient), malignant fibrous histiocytoma of the lower femur (1 patient), parosteal osteosarcoma (1 patient), and periosteal osteosarcoma (1 patient). The remaining patients suffered from conventional osteogenic sarcomas. The size of the defect ranged from 12 to 16 cm in length. Skin flap necrosis after tumor resection was the most common complication encountered. Other complications included peroneal nerve involvement in one case and rupture of the arterial anastomosis in another. All transferred fibulas progressed to union within 7-9 months. Union time of both upper and lower ends of the fibula and time of appearance of periosteal reaction were identical. In evaluating periosteal hypertrophy of the fibula, the hypertrophy (de Boer) index (de Boer HD, Wood MB, J Bone Joint Surg 1989;71B:374-378) proved unreliable. False positive results are obtained, when callus formation around the lower end of the femur is far more abundant than at the upper end of the fibula. For this reason, we introduced the graft index. The latter is the ratio between the diameter of the graft at its thinnest portion at latest follow-up to its diameter on the day of operation, as calculated on plain radiographs. Two of the viable fibulas developed stress fractures after plate removal. Functional and quality-of -life results were satisfactory. It is concluded that the free vascularized fibular graft remains a valuable reconstruction option after the resection of tumors around the knee, provided certain precautions are followed. First, before closure of the wound, the skin flaps should be assessed for their viability. Necrotic parts should be excised. Stable fixation is a necessary prerequisite at the time of operation. Removal of the fixation device should not be guided by union or periosteal hypertrophy, but by true widening of the medullary canal., (Copyright 2000 Wiley-Liss, Inc.)
- Published
- 2000
- Full Text
- View/download PDF
7. Surgical and chemotherapeutic treatment of hepatic metastases from carcinoma of the breast.
- Author
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Elias D, Lasser P, Spielmann M, May-Levin F, el Malt O, Thomas H, and Mouriesse H
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Combined Modality Therapy, Evaluation Studies as Topic, Female, Follow-Up Studies, Hepatectomy, Humans, Liver Neoplasms mortality, Liver Neoplasms secondary, Lymph Node Excision, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local surgery, Prognosis, Retrospective Studies, Breast Neoplasms pathology, Liver Neoplasms drug therapy, Liver Neoplasms surgery
- Abstract
To date, no five year survival rates have been reported for patients with hepatic metastases (HM) from breast origin treated by chemotherapy or hormone therapy. This study was done to evaluate whether or not surgical excision of such metastatic disease associated with chemotherapy has any effect on such a poor prognosis. Between May 1985 and September 1988, 22 patients with a diagnosis of isolated (solitary or multiple) HM have been surgically treated. The therapeutic approach also included systemic preoperative and postoperative chemotherapy. Laparotomy findings for those 22 patients are presented. There were benign hepatic lesions in four patients (four different histologic types) and hepatectomy was done in two patients. Diffuse metastatic disease contraindicated any attempt at hepatic resection in six patients. Hepatectomy was possible in 12 patients. There was no postoperative mortality and minimal morbidity. One-half of the patients with metastases had one or more positive lymph nodes at the hepatic pedicule. Median survival time for 12 patients treated by hepatectomy was 37 +/- 9 months after hepatectomy and 42 +/- 3 months after the discovery of HM. Eleven patients had other metastases after an average period of 11.8 months after hepatectomy, and the liver was the first site of recurrence in eight. One patient underwent a hepatectomy twice. Two patients were free of disease 29 to 46 months postoperatively in spite of poor prognostic features on the excised specimen. Although the median survival time was two times better than with usual treatment, we believe this procedure is of doubtful benefit. In this situation, hepatectomy acts as cytoreductive surgical treatment, with the main limiting factor being the relatively low effectiveness of chemotherapy. This type of therapy can be applied only to a restricted number of patients, and if we decide to proceed with this study, we will have to modify the protocol of chemotherapy radically.
- Published
- 1991
8. [Synchronous cancers of the esophagus and of the ORL area: results of combined treatments with esophagectomy (28 cases)].
- Author
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Elias D, Mamelle G, el Malt O, Luboinski B, Schwaab G, Spielmann M, Girinsky T, Nitenberg G, Kac J, and Lasser P
- Subjects
- Carcinoma, Squamous Cell mortality, Combined Modality Therapy, Esophageal Neoplasms mortality, Humans, Male, Neoplasms, Multiple Primary mortality, Otorhinolaryngologic Neoplasms mortality, Postoperative Period, Prognosis, Retrospective Studies, Survival Rate, Carcinoma, Squamous Cell therapy, Esophageal Neoplasms therapy, Esophagus surgery, Neoplasms, Multiple Primary therapy, Otorhinolaryngologic Neoplasms therapy
- Abstract
Twenty-eight patients with synchronous esophageal and head and neck epidermoid cancers have been treated by a combined protocol including esophagectomy. Seventy-nine percent received pre-operative chemotherapy, 50% had resection of the head and neck lesion at the same time as the esophagectomy and 79% received post-operative irradiation. Two patients died during the post-operative period (7%), and 1, 2 and 3-yr survival rate (Kaplan-Meier) was respectively 64, 32 and 27%. Contrary to our initial assumption, there was no significant decrease in survival compared to patients operated on for an isolated esophageal cancer. The patients were divided into 4 very simple prognostic groups based on the T and N stages of the clinical pre-therapeutic TNM classification: T1 or T2 for esophageal lesions and different T or N stages according to the prognosis for head and neck lesions. A study of each group tended to show that esophagectomy was beneficial except in cases of synchronous T2 esophageal cancer and locally advanced head and neck cancer (there was 2-yr survival in this group). The 28 patients studied represent a particular population which presented 91 cancerous localisations during the duration of the study (mean: 3.25 localisations per patient).
- Published
- 1991
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