64 results on '"Majid Eshghi"'
Search Results
2. The Two-Point Technique for Fluoroscopic-Guided Endoscopic Procedures in Urology: A Validation Study
- Author
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Neel Patel, Majid Eshghi, Ariel Schulman, Michael Iorga, John Phillips, Rogerio Huang, Jonathan Wagmaister, Sean Fullerton, and Muhammad Choudhury
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Adult ,Male ,medicine.medical_specialty ,Validation study ,Urology ,Radiation Dosage ,Young Adult ,Humans ,Medicine ,Fluoroscopy ,Prospective Studies ,Ureteroscopy ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Endoscopy ,Patient exposure ,Middle Aged ,Radiation Exposure ,cardiovascular system ,Regression Analysis ,Female ,Radiology ,business - Abstract
Introduction: The widespread use of diagnostic and therapeutic ionizing radiation raises concerns regarding excessive occupational and patient exposure. In this study, we test a novel fluo...
- Published
- 2019
3. Finding the Next Resident Physicians in the COVID-19 Global Pandemic: An Applicant Survey on the 2020 Virtual Urology Residency Match
- Author
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Evan Spencer, John Phillips, Cindy Christiano, Lori L. Dyer, Paul Zelkovic, Majid Eshghi, David Ambinder, Sean Fullerton, Muhammad Choudhury, Nathan C. Wong, and Gerald Matthews
- Subjects
Adult ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Interview ,business.industry ,Urology ,COVID-19 ,Internship and Residency ,Online Systems ,Preference ,Interviews as Topic ,Pandemic ,Job Application ,Medicine ,Humans ,Lower cost ,Female ,business ,Training program ,Virtual platform ,Multiple choice - Abstract
OBJECTIVE To assess interviewing applicant perceptions of a virtual urology residency interview in the setting of changes mandated by COVID-19 and to determine applicant preference for virtual or in person interviews. Applicant perceptions of multiple interview components were queried to identify program specific and interview modality specific strengths or weaknesses in the 2020 to 2021 Urology Match. METHODS A 12 question multiple choice and free text survey was emailed to 66 virtually interviewed applicants for open residency positions at a metropolitan training program after conclusion of interviews. Items of interest included interview type preference, overall interview impression, and recommendations for improvement. RESULTS A total of 50 of 66 (76%) applicants completed the survey corresponding to approximately 11% of the 2020 national urology applicant pool. A total of 49 of 50 (96%) respondents assessed faculty interaction and the virtual platform positively. A total of 38 of 50 (76%) was satisfied with their resident interaction and 32 of 50 (64%) applicants stated they were able to satisfactorily evaluate the site and program. Ultimately, 39 of 50 (78%) respondents would have preferred an in person interview to our virtual interview. Respondents cited challenges in assessing program culture and program physical site virtually. CONCLUSION The majority of survey respondents indicated a preference for in person interviews. A smaller proportion of applicants preferred virtual interviews citing their convenience and lower cost. Efforts to improve the virtual interview experience may focus on improving applicant-resident interaction and remote site assessment.
- Published
- 2021
4. MP04-14 COMPLICATIONS OF ENDOVASCULAR STAPLING DEVICES DURING MINIMALLY INVASIVE RADICAL NEPHRECTOMY: AN UPDATED REVIEW OF THE FOOD AND DRUG ADMINISTRATION DATABASE FROM 2009-2019
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Nikhil Gopal and Majid Eshghi
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Food and drug administration ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Invasive surgery ,cardiovascular system ,medicine ,Renal vessels ,Ligation ,business ,Nephrectomy ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:With the advent of minimally invasive surgery, ligation of major renal vessels during radical nephrectomy is accomplished using endovascular staples as opposed to sutures...
- Published
- 2020
5. Metastatic Colorectal Adenocarcinoma in a Bifid Ureter
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Nikhil Gopal, Michael Stern, Neel Patel, Majid Eshghi, and Gerald Matthews
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medicine.medical_specialty ,Urology ,bifid ureter ,030232 urology & nephrology ,Case Reports ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Ureter ,Biopsy ,medicine ,Enhancing Lesion ,Ureteroscopy ,Hydronephrosis ,medicine.diagnostic_test ,business.industry ,medicine.disease ,colorectal adenocarcinoma ,Lymphatic system ,medicine.anatomical_structure ,secondary ureteral metastasis ,030220 oncology & carcinogenesis ,Radiology ,ureteroscopy ,Bifid ureter ,business - Abstract
Background: Secondary malignancies of the ureter are uncommon. We report the diagnosis and management of metastatic colon cancer to the bifurcation of a bifid ureter. Case Presentation: A 59-year-old man presented with diffuse metastasis with right hydronephrosis in both renal moieties of a partially duplicated system and an enhancing lesion within the proximal common ureter. Ureteral biopsy was positive for colorectal adenocarcinoma. The patient was subsequently started on palliative chemoradiation. Conclusion: The ureter is a rare location for hematogenous/lymphatic metastases. When a ureteral mass is present on imaging, ureteroscopy should be performed to characterize the extent of tumor and to rule out secondary malignancy.
- Published
- 2019
6. Device-Related Adverse Events During Percutaneous Nephrolithotomy: Review of the Manufacturer and User Facility Device Experience Database
- Author
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Sensuke Konno, Majid Eshghi, John Phillips, Jonathan Bloom, Ariel Schulman, Nikil Uppaluri, Neel Patel, and Muhammad Choudhury
- Subjects
medicine.medical_specialty ,Databases, Factual ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Hemorrhage ,Nephrolithotomy, Percutaneous ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,User Facility ,Intraoperative Complications ,Percutaneous nephrolithotomy ,Adverse effect ,Upper urinary tract ,business.industry ,Foreign Bodies ,Surgical Instruments ,Surgery ,Equipment failure ,Logistic Models ,030220 oncology & carcinogenesis ,Equipment Failure ,Urinary Calculi ,business - Abstract
Percutaneous nephrolithotomy (PCNL) is an established technique for removal of large stones from the upper urinary tract. It is a complex multistep procedure requiring several classes of instruments that are subject to operator misuse and device malfunction. We report device-related adverse events during PCNL from the Manufacturer and User Facility Device Experience (MAUDE) database using a recently developed standardized classification system.The MAUDE database was queried for "percutaneous nephrolithotomy" from 2006 to 2016. The circumstances and patient complications associated with classes of devices used during PCNL were identified. We then utilized a novel MAUDE classification system to categorize clinical events. Logistic regression analysis was performed to identify associations between device classes and severe adverse events.A total of 218 device-related events were reported. The most common classes included: lithotripter 53 (24.3%), wires 43 (19.7%), balloon dilators 30 (13.8%), and occlusion balloons 28 (12.8%). Reported patient complications included need for a second procedure 12 (28.6%), bleeding 8 (19.0%), retained fragments 7 (16.7%), prolonged procedure 4 (9.5%), ureteral injury 2 (4.8%), and conversion to an open procedure 3 (7.1%). Using a MAUDE classification system, 176 complications (81%) were Level I (mild/none), 26 (12%) were Level II (moderate), 15 (7%) were Level III (severe), and 1 (0.5%) was Level IV (life threatening). On univariate analysis, balloon dilators had the highest risk of Level II-IV complications compared with the other device classes [odds ratio: 4.33, confidence interval: 1.978, 9.493, p 0.001]. The device was evaluated by the manufacturer in 93 (42.7%) cases, with 54.8% of reviewed cases listing the source of malfunction as misuse by the operator.PCNL is subject to a wide range of device-related adverse events. A MAUDE classification system is useful for standardized, clinically-relevant reporting of events. Our findings highlight the importance of proper surgeon training with devices to maximize efficiency and decrease harm.
- Published
- 2017
7. Percutaneous and Endoscopic Management of Nephrolithiasis in a Patient with Five Native Ureters (Trifid Right and Bifid Left Collecting System)
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Neel Patel, Jonathan Bloom, Nikil Uppaluri, David M. Schwalb, Majid Eshghi, Suraj Parikh, Andrew I. Fishman, Mark Ferretti, and Michael Iorga
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medicine.medical_specialty ,Percutaneous ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Urinary system ,030232 urology & nephrology ,Multimodal therapy ,Case Report ,Endoscopic management ,Collection system ,renal stones ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Ureter ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine ,percutaneous nephrolithotomy ,Ureteroscopy ,ureteroscopy ,business ,Percutaneous nephrolithotomy - Abstract
Triplication of the ureter is a rare urologic finding that has been well described in the literature. Patients can present with urinary tract infections, incontinence, and calculi. We present the case of a patient with extensive stone burden with right trifid and left bifid collecting systems. Stone management was performed with a multimodal approach using a combination of endoscopic and percutaneous approaches. Our systematic and staged approach highlights a method for efficacious stone treatment in a complex endourologic case.
- Published
- 2018
8. Contemporary Trends in Percutaneous Nephrolithomy Across New York State: A Review of the Statewide Planning and Research Cooperative System
- Author
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John Phillips, Sean Fullerton, Majid Eshghi, Muhammad Choudhury, Neel Patel, Jonathan Bloom, Ariel Schulman, Suraj Parikh, and Jonathan Wagmaister
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Male ,medicine.medical_specialty ,Percutaneous ,Hospitals, Low-Volume ,Databases, Factual ,Urology ,media_common.quotation_subject ,medicine.medical_treatment ,030232 urology & nephrology ,New York ,Nephrolithotomy, Percutaneous ,Ureteroscopy and Percutaneous Procedures ,03 medical and health sciences ,0302 clinical medicine ,State (polity) ,medicine ,Humans ,Longitudinal Studies ,Percutaneous nephrolithotomy ,Stone disease ,media_common ,Nephrostomy, Percutaneous ,business.industry ,Medicaid ,General surgery ,Data Collection ,Length of Stay ,Patient Discharge ,United States ,Socioeconomic Factors ,030220 oncology & carcinogenesis ,Female ,business ,Hospitals, High-Volume - Abstract
Introduction and Objectives: Percutaneous nephrolithotomy (PCNL) is a complex multistep surgery that has shown a steady increase in use for the past decade in the United States. We sought to evaluate the trends and factors associated with PCNL usage across New York State (NYS). Our goal was to characterize patient demographics and socioeconomic factors across high-, medium-, and low-volume institutions. Materials and Methods: We searched the NYS, Statewide Planning and Research Cooperative System (SPARCS) database from 2006 to 2014 using ICD-9 Procedure Codes 55.04 (percutaneous nephrostomy with fragmentation) for all hospital discharges. Patient demographics including age, gender, race, insurance status, and length of hospital stay were obtained. We characterized each hospital as a low-, medium-, or high-volume center by year. Patient and hospital demographics were compared and reported using chi-square analysis and Student's t-test for categorical and continuous variables, respectively, with statistical significance as a p-value of
- Published
- 2019
9. Device Malfunctions and Complications Associated with Benign Prostatic Hyperplasia Surgery: Review of the Manufacturer and User Facility Device Experience Database
- Author
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Jonathan Bloom, Ariel Schulman, John Phillips, Neel Patel, Sean Fullerton, Majid Eshghi, Michael Iorga, Muhammad Choudhury, Nikil Uppaluri, and Sensuke Konno
- Subjects
Male ,medicine.medical_specialty ,Databases, Factual ,Urology ,medicine.medical_treatment ,Enucleation ,Prostatic Hyperplasia ,030232 urology & nephrology ,Lasers, Solid-State ,computer.software_genre ,urologic and male genital diseases ,Holmium ,03 medical and health sciences ,0302 clinical medicine ,Prostate ,Outcome Assessment, Health Care ,medicine ,Humans ,Adverse effect ,Transurethral resection of the prostate ,Endoscopes ,Prostatectomy ,Univariate analysis ,Database ,business.industry ,Transurethral Resection of Prostate ,Endoscopy ,Hyperplasia ,medicine.disease ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Transurethral and Lower Tract Procedures ,Urologic Surgical Procedures ,Equipment Failure ,Laser Therapy ,Morcellator ,Complication ,business ,computer - Abstract
Introduction and Objectives: Multiple surgical therapies for benign prostatic hyperplasia (BPH) have been developed to decrease complications and increase provider efficiency. We investigated contemporary BPH treatment device-related adverse events by searching a publicly available database. Materials and Methods: The Manufacturer and User Facility Device Experience (MAUDE) database was queried for contemporary BPH treatments. All devices were evaluated for malfunction, patient complications, and manufacturer review. The MAUDE adverse event classification system was used to standardize complications. Univariate analysis was performed to identify associations between BPH devices and adverse events. Results: A total of 2567 reports were identified: transurethral resection of the prostate (TURP) 197 (7.67%), holmium laser enucleation of the prostate (HoLEP) 39 (1.52%), GreenLight™ 2315 (90.2%), and UroLift(®) 16 (0.62%). The most common deviations for each modality included cutting loop detachment during TURP 116 (58.9%), morcellator dysfunction for HoLEP 23 (58.9%), tip fracture/detachment for GreenLight (68.8%), and failure to deploy during UroLift 10 (62.5%). Only 18 (0.7%) patients required medical/surgical management (MAUDE II–IV) due to a device complication. No significant relationship was seen between each modality and complications; however, morcellator use (27.8%) was observed in higher grade complications. Manufacturer review occurred in 61.7% of cases, with 41.3% of reviewed cases finding the operator the cause of the malfunction. Conclusion: Each BPH modality investigated had minimal patient harm with over 99% of patients experiencing no complication after device malfunction. Of note, great care should be taken with morcellator use during HoLEP as it had the greatest number of MAUDE II to IV complications among all devices. Manufacturer review revealed that over 40% of cases were due to misuse by the user. Therefore, urologists should select the modalities they are most familiar with to decrease patient harm and prevent device malfunctions.
- Published
- 2019
10. MP23-11 THE CONTINUOUS RENAL PELVIC DECOMPRESSION TECHNIQUE DURING URETEROSCOPY
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Neel Patel, Sean Fullerton, John Phillips, Jonathan Wagmaister, Cristina Fox, and Majid Eshghi
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Decompression ,Urology ,Ureteral stone ,food and beverages ,Postoperative sepsis ,urologic and male genital diseases ,Renal pelvic ,Surgery ,Medicine ,Ureteroscopy ,business - Abstract
INTRODUCTION AND OBJECTIVES:Ureteroscopy for renal and ureteral stone disease is a low-risk procedure with minimal risks of serious complications, however, the rate of postoperative sepsis can be a...
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- 2019
11. Endoscopic Management of Distal Ureteral Strictures
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Michael Zhang, Ali Fathollahi, Joel Hillesohn, and Majid Eshghi
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medicine.medical_specialty ,Meatotomy ,business.industry ,Psoas hitch ,medicine ,Balloon dilation ,Boari flap ,Ureteral Stricture ,Ureteral stents ,Virtual endoscopy ,Endoscopic management ,business ,Surgery - Published
- 2018
12. V03-03 PERCUTANEOUS RESECTION OF BULKY RENAL PELVIS AND CALYCEAL TUMORS
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Sameh Naim, Jonathan Wagmaister, Akhil Saji, and Majid Eshghi
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medicine.medical_specialty ,Standard of care ,medicine.anatomical_structure ,Percutaneous ,Upper tract ,business.industry ,Urology ,medicine ,Radiology ,business ,Renal pelvis ,Urothelial carcinoma ,Resection - Abstract
INTRODUCTION AND OBJECTIVE:The standard of care for upper tract urothelial carcinoma (UTUC) is radical nephroureterectomy; however, certain patient populations such patients with significant medica...
- Published
- 2020
13. PD64-04 DEVICE MALFUNCTIONS AND COMPLICATIONS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA (BPH) SURGERY: REVIEW OF THE MANUFACTURER AND USER FACILITY DEVICE EXPERIENCE (MAUDE) DATABASE
- Author
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Nikil Uppaluri, Sensuke Konno, Majid Eshghi, Muhammad Choudhury, Sean Fullerton, Jonathan Bloom, Ariel Schulman, Neel Patel, John Phillips, and Michael Iorga
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medicine.medical_specialty ,business.industry ,Urology ,General surgery ,medicine ,User Facility ,Benign prostatic hyperplasia (BPH) ,medicine.disease ,business - Published
- 2018
14. Surveillance of the Upper Tract After Conservative Treatment
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Majid Eshghi and Joel Hillelsohn
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,Upper endoscopy ,Flexible cystoscopy ,Cystoscopies ,Conservative treatment ,Upper tract ,medicine ,Ureteroscopy ,business ,Endoscopic treatment ,Urothelial carcinoma - Abstract
Surveillance is essential following endoscopic treatment for upper tract urothelial carcinoma. However unlike lower tract disease, surveillance cannot be performed in an outpatient basis. It is therefore critical to have a multidisciplinary approach to ensure follow-up. Conservative treatment which involves multiple invasive procedures can be cumbersome, for the patient and constant physician–patient dialogue must be maintained. We will outline the optimal approach in explaining to a patient and their families, what surveillance entails. Our surveillance protocol involves flexible cystoscopy, CT or MR urogram, and upper endoscopy in first 3 months. This is followed by repeat ureteroscopy, cytologies, cystoscopies, and imaging in 3–6 month intervals.
- Published
- 2018
15. Rigid Uretero-Resectoscopic Management of Ureteral Tumors
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Majid Eshghi and Joel Hillelsohn
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medicine.medical_specialty ,business.industry ,Mitomycin C ,Patient preference ,Resection ,Surgery ,Lesion ,Urothelial cell carcinoma ,Upper tract ,Medicine ,medicine.symptom ,Stage (cooking) ,business ,Pathological - Abstract
Ureteroscopic resection of upper tract is indicated by patient preference, medical comorbidities, and location/size of tumor. The literature on ureteral recurrence reports a recurrence rate of 48% for low grade and 60% for high grade, but the real recurrence rate is likely to be higher. Risk factors for recurrence include size >2 cm, grade, prior history of urothelial cell carcinoma and stage. The most important factor appears to be grade. Patients who failed conservative therapy and had a delayed radical nephroureterectomy had similar disease-specific survival and pathological stage to those who choose immediate radical nephroureterectomy. In our experience, ureteral tumors are best treated with ureteraoresectoscope. One must be careful with resecting near vessels such as the iliacs in the mid-ureter. In many cases, the resection will need to be staged secondary to the bulky nature of the tumor. If the lesion appears to be extensive or high grade, we instill Mitomycin C at the end of the procedure.
- Published
- 2018
16. Analysis of Conservative Treatment of Upper Tract Urothelial Carcinoma
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Ariel Schulman, Majid Eshghi, and Joel Hillelsohn
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Conservative treatment ,medicine.medical_specialty ,Percutaneous ,Upper tract ,business.industry ,General surgery ,medicine ,Treatment options ,business ,After treatment ,Prospective evaluation ,Urothelial carcinoma ,Resection - Abstract
A survey of literature on UTUC shows a mix set of results on efficacy and outcome of conservative treatment. There are no standardized templates for ureteroscopic or percutaneous resection techniques nor the adjuvant treatment options. The assumptions of what institutes a diagnosis or success after treatment also remain unclear. The conservative management of UTUC is a work in progress requiring a multicenter prospective evaluation to provide more clear parameters to follow.
- Published
- 2018
17. Intracavitary Topical Chemo and Immune Therapy of the Upper Tract
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Majid Eshghi, Joel Hillelsohn, and Arthur D. Smith
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Carcinoma in situ ,Mitomycin C ,Urology ,medicine.disease ,Gemcitabine ,Immune therapy ,Upper tract ,Topical agents ,Adjuvant therapy ,medicine ,business ,Adjuvant ,medicine.drug - Abstract
Endourologic management of upper tract urothelial carcinoma has become the preferred treatment in selected groups of patients. However, recurrence is high and there is a large interest in utilizing adjuvant topical agents as used in the lower tract. Many agents have been studied, but they are less efficacious than they are in the lower tract. This is likely due to incomplete staging, difficult delivery, and incomplete resection. There is evidence that primary BCG for isolated carcinoma in situ has some efficacy, but the evidence is not robust. There is mixed evidence for the use of adjuvant BCG, Mitomycin C, and Adriamycin. In our institution (ME), we utilize adjuvant Mitomycin C for a 6-week course in the office following resection. The future of adjuvant therapy likely lies in products such as MitoGel© that coat the upper tract.
- Published
- 2018
18. Instruments for Upper Tract Biopsy and Treatment
- Author
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Ariel Schulman and Majid Eshghi
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Forceps ,Upper tract ,Specimen collection ,Biopsy ,medicine ,Ureteroscopes ,Retrograde ureteral ,Ureteroscopy ,Radiology ,business ,Upper urinary tract - Abstract
From the introduction of endoscopic approaches to genitourinary disease at the beginning of the nineteenth century to advances in 1970s that ushered in the current era of Endourology, the field has undergone continuous growth based on improved visualization, advances in scope design and instrument innovation. Currently available techniques offer access to the entire urinary tract via a retrograde ureteral or antegrade percutaneous approach for the inspection, biopsy, and treatment of the spectrum of benign and malignant pathology. While urine studies and cross-sectional imaging are utilized in the initial evaluation, direct visual inspection, and biopsy is required for the assessment of any abnormal findings. The current generation of digital flexible ureteroscopes are lighter and less cumbersome than their predecessors with better image quality. Instruments including forceps, baskets, and resection loops are available to maximize the diagnostic yield of endoscopic biopsy. Despite progress, it is critical to recognize that undergrading and understaging remain a significant concern even for experienced practitioners. This can best be tempered with a comprehensive evaluation of the entire urothelium, systematic approach to specimen collection and close clinical follow-up. In this chapter, we review basic endoscopic techniques for the biopsy of upper urinary tract lesions.
- Published
- 2018
19. Percutaneous Resection of Renal Pelvis and Calyceal Tumors
- Author
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Majid Eshghi, Roger Yau, and Joel Hillelsohn
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medicine.medical_specialty ,Percutaneous ,medicine.anatomical_structure ,medicine.diagnostic_test ,business.industry ,Biopsy ,Medicine ,Renal function ,Co morbidity ,Radiology ,business ,Renal pelvis ,Resection - Abstract
This chapter describes in details all the aspects of percutaneous management of renal pelvis tumors. These tumors are mostly low grade and bulky and the resection is with the intent of complete, curative and sometimes palliative purposes. Majority of these patients have compromised renal function or have significant co morbidities. The technical aspects of resection, follow up biopsy and surveillance are described with video samples of different stages. There will also be description of intracavitary treatment.
- Published
- 2018
20. PD30-08 DEVICE-RELATED DEVIATION DURING PERCUTANEOUS NEPHROLITHOTOMY: REVIEW OF THE MANUFACTURER AND USER FACILITY DEVICE EXPERIENCE (MAUDE) DATABASE
- Author
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Neel Patel, Muhammad Choudhury, Majid Eshghi, Sensuke Konno, Nikil Uppaluri, Ariel Schulman, and John Phillips
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,Medical physics ,User Facility ,Percutaneous nephrolithotomy ,business - Published
- 2017
21. MP92-06 ANALYSIS OF 30 DAY READMISSION TO AN ADULT UROLOGY SERVICE: ASSESSMENT OF RISK FACTORS AND BASIS FOR A QUALITY INDEX METRIC
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Michael Stern, Alex Ward, Majid Eshghi, Suraj Parikh, Gerald J. Matthews, John Phillips, Muhammad Choudhury, and Sean Fullerton
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Service (business) ,Pediatrics ,medicine.medical_specialty ,Index (economics) ,business.industry ,Urology ,media_common.quotation_subject ,Emergency medicine ,medicine ,Quality (business) ,Metric (unit) ,business ,media_common - Published
- 2017
22. Applications of Urologic Ultrasound During Pregnancy
- Author
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Majid Eshghi
- Subjects
Gynecology ,medicine.medical_specialty ,Pregnancy ,030219 obstetrics & reproductive medicine ,business.industry ,Ultrasound ,030232 urology & nephrology ,2d ultrasound ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Renal colic ,Radiology ,medicine.symptom ,business ,Hydronephrosis - Abstract
This chapter addresses the diagnostic and therapeutic urologic applications of ultrasound during pregnancy including assessment of hydronephrosis and renal colic, ultrasound-guided endoscopic procedures. 2D ultrasound is generally considered the safest and the first radiologic modality for evaluation of hydronephrosis during pregnancy. Although MRI is considered safe during pregnancy, its sensitivity for stone diagnosis is low.
- Published
- 2016
23. Application of Urologic Ultrasound in Pelvic and Transplant Kidneys
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Majid Eshghi
- Subjects
body regions ,medicine.medical_specialty ,surgical procedures, operative ,business.industry ,Ultrasound ,Ultrasound imaging ,Medicine ,Radiology ,business ,humanities - Abstract
This chapter will address the assessment of conditions associated with congenital pelvic and transplant kidneys utilizing ultrasound imaging. The diagnostic and interventional role of ultrasound in allografts will also be reviewed.
- Published
- 2016
24. MP12-20 PREDICTORS OF 30-DAY COMPLICATIONS AND HOSPITAL READMISSIONS FOLLOWING ADRENALECTOMY
- Author
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Ervin Teper, Peter Homel, Mark Cogburn, Majid Eshghi, John Phillips, and Ariel Schulman
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Multivariate statistics ,medicine.medical_specialty ,Surgical approach ,Multivariate analysis ,business.industry ,Urology ,Adrenalectomy ,medicine.medical_treatment ,Perioperative ,medicine.disease ,Acs nsqip ,Surgery ,Diabetes mellitus ,Emergency medicine ,Medicine ,business ,Complication - Abstract
INTRODUCTION AND OBJECTIVES: Minimally invasive adrenalectomy (laparoscopic and robot-assisted) may offer lower postoperative morbidity and mortality. The purpose of this study is to analyze postoperative complications, readmission rates, and predictors of readmission in minimally invasive adrenalectomy (MIA) using a national outcomes database. METHODS: American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database was used to analyze patients who underwent MIA in 2011 and 2012. Perioperative variables and Clavien complications were analyzed using multivariate regression analysis. P
- Published
- 2016
25. Cold-Knife Retrograde Endopyelotomy: A Long-Term Follow-Up
- Author
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Rajen P. Butani and Majid Eshghi
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,Long term follow up ,Urology ,Ureteropelvic junction ,Cold knife ,Ureteroscopy ,medicine ,Humans ,Kidney Pelvis ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Follow up studies ,Infant ,Treatment options ,Middle Aged ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,business ,Ureteral Obstruction - Abstract
Cold-knife retrograde endopyelotomy is a simple, safe, and effective therapeutic option for primary and secondary symptomatic ureteropelvic junction obstruction (UPJO). Our long-term success rate with negligible complications demonstrates its durability and safety. Retrograde endopyelotomy should be considered a viable first-line treatment option for the management of patients with UPJOs.
- Published
- 2008
26. Urologic Complications in Renal Transplant Recipients by Donor Type
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Majid Eshghi, M. Edye, B. Belletete, A.A. Samadi, S.A. Amukele, R. El-Sabrout, and K. Butt
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Adult ,Male ,Urologic Diseases ,medicine.medical_specialty ,Adolescent ,Urology ,medicine.medical_treatment ,Nephrectomy ,Postoperative Complications ,Living Donors ,medicine ,Humans ,Child ,Aged ,Retrospective Studies ,business.industry ,Graft Survival ,Middle Aged ,Kidney Transplantation ,Surgery ,Renal transplant ,Tissue and Organ Harvesting ,Female ,business - Abstract
Reduced donor morbidity has been established after laparoscopic donor nephrectomy compared with open harvest, but differences in recipient outcomes remain less obvious. We compared the urologic complications in patients receiving kidneys procured by cadaveric, open, and laparoscopic harvest.A retrospective study of all the kidney transplantations performed between January 1998 and December 2003 was undertaken to extract 100 consecutive patients in each group. All urologic complications were obtained and grouped by the type of donor procurement.Overall, 48 of the 276 transplant patients (17%) had urologic complications: 14% of the cadaveric-donor recipients, 20% of the open-donor recipients, and 18% of the laparoscopic-donor recipients. There were no ureteral complications in the laparoscopic group.Laparoscopically procured donor kidneys were associated with significantly fewer recipient ureteral complications than open cadaver or live-donor procurement.
- Published
- 2006
27. Percutaneous Management of Intrarenal Calculi
- Author
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Majid Eshghi and Michael Degen
- Subjects
medicine.medical_specialty ,Staghorn calculus ,Percutaneous ,business.industry ,medicine.medical_treatment ,medicine ,Nephrostomy tube ,Horseshoe kidney ,Transplant kidney ,Radiology ,Lithotripsy ,medicine.disease ,business - Published
- 2014
28. Accuracy of Three-Dimensional CT Angiography for Preoperative Vascular Evaluation of Laparoscopic Living Renal Donors
- Author
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Majid Eshghi, Robert Simon, Khalid Butt, Srinivas Rajamahanty, and Michael Edye
- Subjects
Adult ,Male ,Nephrology ,medicine.medical_specialty ,Adolescent ,Urology ,Urinary system ,medicine.medical_treatment ,Kidney ,Nephrectomy ,Sensitivity and Specificity ,Renal Veins ,Renal Artery ,Internal medicine ,Preoperative Care ,Living Donors ,Operative report ,Humans ,Medicine ,Laparoscopy ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Angiography ,Middle Aged ,Kidney Transplantation ,Endoscopy ,Circulatory system ,Female ,Radiology ,business ,Tomography, Spiral Computed - Abstract
Purpose: A retrospective review of preoperative three-dimensional (3D) CT and the operative findings during laparoscopic donor nephrectomy. Patients and Methods: Fifty-four consecutive patients underwent laparoscopic donor nephrectomy. Of these patients, 51 had preoperative 3D reconstructed CT scans. Each radiologic report was compared with the operative report. Results: The 3D CT correctly identified the arteries in 98% of the patients and the veins in 96%. Conclusions: Preoperative CT angiography can accurately identify the renal vasculature.
- Published
- 2005
29. 308 ALTERNATIVE THERAPEUTIC APPROACH USING VITAMIN K3 AND D-FRACTION FOR RENAL CELL CARCINOMA TARGETING CELL CYCLE AND CHROMATIN STRUCTURE
- Author
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Majid Eshghi, Muhammad Choudhury, Andrew I. Fishman, Bobby Alexander, Michael Degen, and Sensuke Konno
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Urology ,Cell ,Cell cycle ,medicine.disease ,Primary tumor ,Chromatin ,medicine.anatomical_structure ,Renal cell carcinoma ,Internal medicine ,medicine ,Myeloid-derived Suppressor Cell ,Cancer research ,Tumor necrosis factor alpha ,business ,Clear cell - Abstract
and 30 days following surgical removal of renal masses from 53 patients with presumed RCC. Samples were analyzed for immunosuppressive cell populations, including regulatory T cells, myeloid derived suppressor cells, inflammatory monocytes and exhausted T cells, and cytokines (IL-1 , IL-5, TNF ). Patients were compared to 10 age and gender matched healthy controls. RESULTS: Characteristics of patients with renal masses and controls are shown in Table 1. The percentage of regulatory T cells and exhausted T cells decreased after tumor removal in patients with clear cell RCC (p 0.01 and p 0.04). There was also an increased percentage of regulatory T cells and exhausted T cells in patients with clear cell RCC as compared to healthy controls (p 0.07 and p 0.007). Patients with stage T3 clear cell RCC had significantly higher levels of protumorigenic cytokines (IL-1 , IL-5 and TNF ) compared to stage T1 tumors (p 0.01, p 0.03 and p 0.02). CONCLUSIONS: Compared to healthy controls, patients with clear cell RCC had increased percentages of two immunosuppressive cell populations. After excision of the primary tumor, these cell populations decreased in number significantly. Serum concentrations of immunosuppressive cytokines were elevated in patients with increased tumor extent. Targeting these specific cell populations and/or cytokines in patients with clear cell RCC may represent a new therapeutic approach to treating advanced disease.
- Published
- 2013
30. Ultrasound of the Gravid and Pelvic Kidney
- Author
-
Majid Eshghi
- Subjects
Pelvic kidney ,medicine.medical_specialty ,Pregnancy ,business.industry ,Ultrasound ,Transplant kidney ,Renal artery stenosis ,medicine.disease ,digestive system diseases ,humanities ,body regions ,surgical procedures, operative ,medicine ,Ultrasound imaging ,Radiology ,Renal colic ,medicine.symptom ,business ,Hydronephrosis - Abstract
This chapter addresses the assessment of hydronephrosis and renal colic during pregnancy, as well as the assessment of conditions associated with congenital pelvic and transplant kidneys utilizing ultrasound imaging.
- Published
- 2013
31. 2058 PREVENTIVE EFFECT OF SPECIFIC ANTIOXIDANT ON OXIDATIVE RENAL CELL INJURY FACILITATING RENAL CRYSTAL FORMATION: IN VITRO AND IN VIVO STUDIES
- Author
-
Muhammad Choudhury, Andrew I. Fishman, Majid Eshghi, Alexandria C. Lynch, David A. Green, and Sensuke Konno
- Subjects
Pathology ,medicine.medical_specialty ,Antioxidant ,business.industry ,In vivo ,Urology ,medicine.medical_treatment ,Cell injury ,medicine ,Oxidative phosphorylation ,Pharmacology ,business ,In vitro - Published
- 2011
32. New cavitron system (CUSA/CEM): Its application for kidney surgery
- Author
-
Joseph C. Addonizio, Muhammad Choudhury, Junro Muraki, Majid Eshghi, and Emilio Lastarria
- Subjects
medicine.medical_specialty ,Ultrasonic Therapy ,Urology ,medicine.medical_treatment ,Blood Loss, Surgical ,Aspirator ,Suction ,Kidney ,Nephrectomy ,Electrocoagulation ,Resection ,Dogs ,Blood loss ,medicine.artery ,Animals ,Medicine ,Kidney surgery ,Renal artery ,business.industry ,Surgery ,Blood ,medicine.anatomical_structure ,business - Abstract
A new Cavitron Ultrasonic Surgical Aspirator system (CUSA/CEM), which contains electrocautery function at the hand piece, was used for partial nephrectomies in dogs without clamping the renal artery. The advantages of this new device (CUSA/CEM) over the original CUSA are: (1) it enabled more precise resection of the tissue in a dry field, (2) shorter operating time, and eventually (3) helpful for reduction of blood loss. The microscopic examination of the resected kidney revealed minimal reaction and damage to the adjacent kidney tissue as compared with the effect by electrocautery or microwave tissue coagulator.
- Published
- 1993
33. Endoscopic removal of a retained pelvic drain fragment with CO2 pneumoperitoneum
- Author
-
Majid Eshghi and Amir Arsanjani
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Cystectomy ,Pneumoperitoneum ,Co2 pneumoperitoneum ,Medicine ,Humans ,Local anesthesia ,Kidney Pelvis ,Aged ,Hysterectomy ,medicine.diagnostic_test ,business.industry ,Endoscopy ,Pelvic cavity ,Carbon Dioxide ,medicine.disease ,Surgery ,body regions ,medicine.anatomical_structure ,Drainage ,business ,Complication ,Tomography, X-Ray Computed ,Pneumoperitoneum, Artificial - Abstract
Retained drains are an infrequent and usually avoidable postsurgical complication. There are few reports in the contemporary literature regarding minimally invasive techniques to remove retained postsurgical drains. We present a novel technique for the removal of a retained deep pelvic Jackson-Pratt drain by means of a fluoroscopically guided transurethral endoscopic technique with minimal CO(2) pneumoperitoneum performed safely through a newly transected urethral stump under local anesthesia. The use of CO(2) pneumoperitoneum in place of saline irrigation is less likely to be associated with any untoward postoperative complications. This novel and effective technique will serve as a useful adjunct to the minimally invasive management of retained pelvic drains in postoperative patients who have undergone cystectomy and/or hysterectomy.
- Published
- 2009
34. Benefits of liver transplantation surgical techniques in the management of extensive retroperitoneal tumors
- Author
-
Majid Eshghi, Muhammad Choudhury, Manoj K. Singh, Marcelo E. Facciuto, Juan P. Rocca, Caroline Rochon, Patricia A. Sheiner, Manuel I. Rodriguez Davalos, and David M. Schwalb
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Vena Cava, Inferior ,Liver transplantation ,Inferior vena cava ,Cohort Studies ,Medicine ,Hepatectomy ,Humans ,Retroperitoneal Neoplasms ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Carcinoma ,Vascular surgery ,Middle Aged ,Survival Analysis ,Retroperitoneal Neoplasm ,Hemostasis, Surgical ,Surgery ,Cardiac surgery ,Liver Transplantation ,Radiography ,Treatment Outcome ,medicine.vein ,Cardiothoracic surgery ,cardiovascular system ,Female ,business ,Abdominal surgery - Abstract
The potential for massive hemorrhage imposes additional challenge in the management of retroperitoneal tumors. This report details technical considerations for the management of upper retroperitoneal tumors using principles of liver transplantation. A retrospective chart review of patients who underwent surgery for extensive retroperitoneal tumors using techniques for liver transplantation from December 2002 to November 2007 was done. Twenty-four patients (14 males and 10 females with a mean age 57 years) underwent major retroperitoneal surgery. Renal cell carcinoma was the most common tumor seen in 17 patients. Mean tumor dimension was 12.4 cm. Abdominal exposure was achieved via bilateral subcostal incision with upper midline extension. Right hepatic lobe mobilization and isolation from the inferior vena cava (IVC) was performed in 23 cases. Fourteen patients had IVC involvement by tumor thrombus, which was infrahepatic in six, retrohepatic in five, and intra-atrial in three patients. Tumor thrombus was removed by cavotomy in seven cases, resection and plasty in four cases, IVC graft reconstruction in two cases, and one patient required IVC and atrial graft reconstruction. Liver resection was needed in seven patients to achieve R0 resection. The Pringle maneuver was used in three patients; total liver vascular isolation with venovenous bypass was required in two cases, transdiaphragmatic intrapericardial IVC control in one case, and cardiopulmonary bypass in one patient. There was no intraoperative or postoperative mortality and mean length of stay was 13 days. Liver transplantation surgical principles help achieve exposure and vascular control of major vascular structures that enable safe resection of these extensive retroperitoneal tumors.
- Published
- 2008
35. Maintenance intravesical bacillusCalmette-guerin for superficial transitional cell carcinoma of bladder
- Author
-
Joseph C. Camilleri, Joseph C. Addonizio, David M. Schwalb, Muhammad Choudhury, and Majid Eshghi
- Subjects
medicine.medical_specialty ,Urinary bladder ,business.industry ,Urology ,Carcinoma in situ ,medicine.medical_treatment ,Immunotherapy ,medicine.disease ,Surgery ,Transitional cell carcinoma ,medicine.anatomical_structure ,Maintenance therapy ,medicine ,Transitional Cell ,In patient ,business ,Complete response - Abstract
Eighteen patients with recurrent and/or multifocal superficial transitional cell carcinomaof the bladder who were rendered tumor free by transurethral resection and were then treated with either a single or second six-week course of induction Bacillus Calmette-Guerin (BCG) therapy, followed by maintenance therapy, were retrospectively reviewed. A 73 percent complete response rate was achieved in those patients treated prophylactically, while a 70 percent complete response rate was observed in patients treated for carcinoma in situ (CIS) with an average follow-up of twenty-nine months. Maintenance therapy may be warranted in those patients able to tolerate it without significant side effects.
- Published
- 1990
36. Establishment of new human prostatic cancer cell line (JCA-I)
- Author
-
Marianna Davidian, Joel Fischer, J.W. Chiao, Patrick L. Wilmot, Joseph C. Addonizio, Lawrence R. Shapiro, Junro Muraki, Muhammad Choudhury, George R. Nagamatsu, and Majid Eshghi
- Subjects
Pathology ,medicine.medical_specialty ,biology ,business.industry ,Urology ,Acid phosphatase ,Aneuploidy ,Karyotype ,medicine.disease ,Staining ,Tissue culture ,medicine.anatomical_structure ,Cell culture ,Prostate ,medicine ,biology.protein ,Cancer research ,Adenocarcinoma ,business - Abstract
The establishment of a new human prostatic cancer cell line is described. This cell line was derived from a poorly to moderately differentiated prostatic adenocarcinoma. It has been maintained in tissue culture for fourteen months and has been passed fifty-two times. This cell line has an ability to form colonies in soft agar suspension cultures, and also is transplantable to nude mice. Tumors grown in nude mice revealed a poorly differentiated adenocarcinoma with positive PSA staining. Acid phosphatase activity was detected in freeze-thawed cells by enzymatic assay. A karyotype analysis demonstrated aneuploidy with a model chromosomal number of 69 and six marker chromosomes.
- Published
- 1990
37. Salvage extracorporeal shockwave lithotripsy after failed distal ureteroscopy
- Author
-
Shahrad Aynehchi, Hiroshi Tazaki, Sensuke Konno, Albert A. Samadi, Majid Eshghi, and Stephen J. Gallo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Ureteral Calculi ,Urology ,medicine.medical_treatment ,Salvage therapy ,Hydronephrosis ,Lithotripsy ,Extracorporeal shockwave lithotripsy ,Ureter ,medicine ,Ureteroscopy ,Humans ,Treatment Failure ,Aged ,Retrospective Studies ,Salvage Therapy ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Distal ureter ,Surgery ,Endoscopy ,medicine.anatomical_structure ,Female ,business ,Ureteral Obstruction - Abstract
When intervention is necessary, controversy remains as to the best treatment modality for stones of the distal ureter. In general, ureteroscopy is favored over extracorporeal shockwave lithotripsy (SWL) as the treatment of choice for distal ureteral stones. Although uncommon, ureteroscopy failures have traditionally necessitated repeat ureteroscopy to retrieve retained stone fragments. We evaluated the efficacy of salvage SWL for failed primary distal ureteroscopy in the community setting.From December 1989 to December 2000, 6099 patients underwent SWL with the Dornier HM4 lithotripter at our institution. We retrospectively identified 31 patients who had undergone the SWL after a failed distal ureteroscopy.The average stone size in these patients was 9.4 mm, the average time interval from ureteroscopy to SWL was 17.2 days, and the average number of shockwaves delivered was 2386. All patients had had stents placed after ureteroscopy. Twenty-seven patients (87%) had resolution of their stone burden after one SWL session. The remaining four patients underwent additional procedures.Ureteroscopy is an effective modality for the treatment of distal ureteral stones. However, when unsuccessful, a salvage procedure may be necessary. Extracorporeal lithotripsy is a less invasive procedure with comparable success rates in the distal ureter. This report suggests that salvage SWL is an appropriate option for patients in whom distal ureteroscopic stone extraction fails.
- Published
- 2002
38. Laryngeal metastasis 7 years after radical nephrectomy
- Author
-
Majid Eshghi, Simpson L. Dee, and Clifton S. Otto
- Subjects
Larynx ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Nephrectomy ,Pathology and Forensic Medicine ,Metastasis ,Renal cell carcinoma ,medicine ,Carcinoma ,Humans ,Carcinoma, Renal Cell ,Laryngeal Neoplasms ,Kidney ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Surgery ,Medical Laboratory Technology ,medicine.anatomical_structure ,Clear cell carcinoma ,business ,Kidney disease - Abstract
Metastasis of renal cell carcinoma to the head and neck, especially the larynx, is an extremely rare event. Most previously reported cases have involved a presenting laryngeal lesion that lead to the discovery of an underlying primary renal cell carcinoma. Even more unusual is the occurrence of an isolated laryngeal metastasis revealing itself years after nephrectomy, with an interim of undetected recurrence. We believe this case to be the first reported example of an isolated supraglottic laryngeal renal cell carcinoma metastasis occurring 7 years after radical nephrectomy. Local excision of such isolated lesions seems to offer a favorable prognosis.
- Published
- 2000
39. Benign soft-tissue neoplasm simulating sarcoma of spermatic cord
- Author
-
Muhammad Choudhury, Majid Eshghi, Joel Fischer, R. H. Andovolu, Heinrich Schutte, R. Evans, and Joseph C. Addonizio
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Benign Soft Tissue Neoplasm ,Urology ,Soft Tissue Neoplasms ,Malignancy ,Spermatic cord ,Diagnosis, Differential ,Scrotum ,medicine ,Humans ,Spermatic Cord ,business.industry ,Myxoma ,Sarcoma ,medicine.disease ,medicine.anatomical_structure ,Genital Neoplasms, Male ,Tissue diagnosis ,Primary sarcoma ,business - Abstract
A large, painless, slow-growing mass arising in the scrotum of a twenty-three-year-old man, which proved to be benign myxoma, simulated a primary sarcoma of the spermatic cord. Only 1 case of myxoma involving the spermatic cord has been reported previously. It is extremely important that multiple microscopic sections of the specimen be examined carefully so that the proper tissue diagnosis can be made. A false diagnosis of malignancy may lead to treatment that is not indicated and that has a high morbidity.
- Published
- 1990
40. Bilateral same session ureteroscopy
- Author
-
Joseph C. Camilleri, Majid Eshghi, and David M. Schwalb
- Subjects
Adult ,Male ,medicine.medical_specialty ,Ureteral Calculi ,Adolescent ,Urology ,urologic and male genital diseases ,Balloon ,Catheterization ,Ureter ,Flexible endoscopy ,medicine ,Humans ,Ureteral Diseases ,Ureteroscopy ,Ureteral dilation ,Hydronephrosis ,medicine.diagnostic_test ,urogenital system ,business.industry ,Endoscopy ,Middle Aged ,medicine.disease ,Dilatation ,female genital diseases and pregnancy complications ,Surgery ,Stent placement ,surgical procedures, operative ,medicine.anatomical_structure ,Female ,Stents ,business - Abstract
During a period of 4 years we performed 15 bilateral 1-session ureteroscopic examinations in 13 patients. Indications included bilateral ureteral and/or renal calculi, unexplained hydronephrosis, hematuria or filling defects, and bilateral ureteral stent placement in situations when conventional retrograde methods of stent placement failed. Balloon or hydraulic intramural ureteral dilation was performed in all cases before rigid or flexible endoscopy. There were no major short-term or long-term complications resulting from bilateral 1-session ureteroscopy.
- Published
- 1994
41. Morphological and physiological changes in the urinary tract associated with ureteral dilation and ureteropyeloscopy: an experimental study
- Author
-
Marianna David Ian, Majid Eshghi, David M. Schwalb, and Israel Franco
- Subjects
medicine.medical_specialty ,Swine ,Urology ,medicine.medical_treatment ,Urinary system ,Balloon ,Kidney ,Ureter ,medicine ,Pressure ,Animals ,Kidney Pelvis ,Ureteroscopy ,Urothelium ,Nephrostomy, Percutaneous ,medicine.diagnostic_test ,business.industry ,Endoscopy ,Dilatation ,Surgery ,medicine.anatomical_structure ,Nephrostomy ,Swine, Miniature ,Female ,business ,Renal pelvis ,Ureteral Obstruction - Abstract
The gross and microscopic effects of four common modes of ureteral dilation and ureteroscopy were examined in 26 renoureteral units in 13 minipigs. Acutely, ureters subjected to mechanical (bougie, Teflon, or balloon) ureteral dilation and ureteropyeloscopy (UPS) demonstrated active mucosal bleeding with multiple sites of perforation, whereas ureters subjected to hydraulic dilation and UPS were significantly less traumatized. Two weeks after mechanical ureteral dilation and UPS, 3 of 6 ureters were obstructed radiographically, whereas all 7 hydraulically dilated ureters were unobstructed. By 6 weeks, all radiographic evidence of obstruction had resolved in the mechanically dilated group. While 5 of 6 mechanically dilated ureters showed extensive scarring with muscle loss 4 to 6 weeks after dilation, no scarring was seen in those ureters dilated hydraulically. Renal pelvic pressure (RPP) was measured continuously with a nephrostomy catheter in vivo during (bougie, Teflon, balloon and hydraulic) ureteral dilation and UPS. Renal pelvic pressure during rigid ureteroscopy approximated the resting pelvic pressure plus the irrigant height above the kidney or set pressure on a hydraulic pump, plus a "scope effect" which was characterized by a 20 to 25 mm. Hg increase in RPP produced by moving the endoscope in the ureter without flow. The effects on RPP of continuous bladder drainage with a uretheral catheter and renal pelvic decompression with an open-ended ureteral catheter passed into the renal pelvis through the ureteroscope working channel were also examined. The maximum RPP was evaluated in vitro in a separate group of 16 freshly harvested pig kidneys of similar weight examined immediately after sacrifice and was found to be 439 mm. Hg. We also studied the immediate and long-term effects of low (120 cm. H2O or 90 mm. Hg) versus high (200 cm. H2O or 150 mm. Hg) RPP on renal histology. Acutely, high pressure caused diffuse denudation and flattening of the caliceal urothelium, submucosal edema and congestion not seen in calyces subjected to low irrigant pressure. Four to six weeks later, there was a higher incidence of columnar metaplasia, subepithelial nests and pericalyceal vasculitis in calyces subjected to high pressure as compared with those subjected to low irrigant pressure. Acutely, renal tubules subjected to high irrigant pressure demonstrated marked vacuolization and degeneration, whereas tubules subjected to low pressure appeared normal. At 4 to 6 weeks, focal scarring was seen in 5 of 7 kidneys subjected to high irrigant pressure, whereas no scarring was noted in all 6 kidneys subjected to low irrigant pressure.(ABSTRACT TRUNCATED AT 400 WORDS)
- Published
- 1993
42. SURGICAL MANAGEMENT OF COMPLEX UPPER RETROPERITONEAL AND UROLOGICAL TUMORS WITH LIVER TRANSPLANT SURGERY TECHNIQUES
- Author
-
Harry A Dorn, Marcel Facciuto, Majid Eshghi, Srinivas Rajamahanty, and Muhammad Choudhury
- Subjects
medicine.medical_specialty ,Transplant surgery ,business.industry ,Urology ,General surgery ,Medicine ,business ,Surgery - Published
- 2009
43. Application of microwave tissue coagulation in partial nephrectomy
- Author
-
Junro Muraki, David M. Schwalb, Joseph C. Addonizio, James Cord, Majid Eshghi, George R. Nagamatsu, and Noel Armenakas
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Cautery ,Blood Loss, Surgical ,Infarction ,Kidney ,Nephrectomy ,Blood Urea Nitrogen ,Dogs ,medicine.artery ,Medicine ,Animals ,Renal artery ,Abscess ,Microwaves ,Intraoperative Care ,business.industry ,medicine.disease ,Hemostasis, Surgical ,Surgery ,medicine.anatomical_structure ,Coagulation ,Hemostasis ,Creatinine ,Female ,business ,Complication - Abstract
Microwave tissue coagulation was used during partial nephrectomy in 10 mongreldogs, without clamping the renal artery. There were no major complications, such as retroperitoneal hematoma, abscess formation, or macroscopic infarction of the kidney tissue related to this new procedure. The advantages of microwave coagulation are reduced blood loss, shorter operative time, and minimal risk of vascular injury.
- Published
- 1991
44. THE RELIABILITY OF URINE DIPSTICKS IN THE EVALUATION OF MICROSCOPIC HEMATURIA IN THE OFFICE-BASED UROLOGIC SETTING
- Author
-
Majid Eshghi, Jason H Lee, John Phillips, and Muhammad Choudhury
- Subjects
Office based ,medicine.medical_specialty ,Microscopic urinalysis ,business.industry ,Urology ,medicine ,Screening method ,Dipstick ,Urine ,Microscopic hematuria ,urologic and male genital diseases ,business - Abstract
462 THE RELIABILITY OF URINE DIPSTICKS IN THE EVALUATION OF MICROSCOPIC HEMATURIA IN THE OFFICE-BASED UROLOGIC SETTING Jason H Lee*, John L Phillips, Majid Eshghi, Muhammad S Choudhury. Valhalla, NY. INTRODUCTION AND OBJECTIVE: The urine dipstick is a routinely used screening method for hematuria. Positive results usually elicit a quantitative microscopic urinalysis. No systematic reviews have correlated the categorical outcomes of increasing degrees of positive urine dipsticks with the quantitative amount of blood found on microscopic urinalysis. METHODS: Two clean-catch urine specimens were obtained
- Published
- 2008
45. V1819: From Davis to da Vinci: The Evolution in the Treatment of Ureteropelvic Junction (UPJ) Obstruction
- Author
-
Israel Franco, Majid Eshghi, Mark F. Chang, and Mauricio Davalos
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Urology ,Medicine ,Ureteropelvic junction ,business ,Surgery - Published
- 2007
46. 34: Cold Knife Retrograde Endopyelotomy: 18 Years Experience and Follow-Up
- Author
-
Srinivas Rajamahanty, Majid Eshghi, and Albert A. Samadi
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Cold knife ,business ,Surgery - Published
- 2004
47. EVIS CYF-200 DIGITAL VIDEOCYSTOSCOPE AND IMAGE FILING SYSTEM
- Author
-
Albert A. Samadi, Sean Fullerton, Majid Eshghi, and Hiroshi Tazaki
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Medical physics ,business ,Minimally invasive procedures - Published
- 1999
48. Technique and trial of continent ileocystostomy
- Author
-
Arthur D. Smith, Majid Eshghi, Kwabena Ansong, Burton Bronsther, and Moneer K. Hanna
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Urinary system ,Urinary Bladder ,Urinary Diversion ,Anastomosis ,Cystectomy ,Abdominal wall ,Surgical anastomosis ,Dogs ,Postoperative Complications ,Urethra ,Stoma (medicine) ,Ileum ,medicine ,Animals ,Trigone of urinary bladder ,Derivation ,business.industry ,Surgery ,Urodynamics ,medicine.anatomical_structure ,Female ,business - Abstract
To overcome the problem of incontinence which failed to respond to standard measures, an animal model was designed for continent diversion without cystectomy. A tapered terminal ileal segment was implanted in a submucosal tunnel on the anterior aspect of the bladder, and the proximal end of the segment was brought out to the abdominal wall as a stoma that is catheterized intermittently. Ileocystostomy provided continent diversion in 10 dogs at intravesical pressures as high as 45 cm H2O, and there were no changes in serum electrolytes, creatinine, or urea nitrogen concentration.
- Published
- 1986
49. Dilatation of Ureteral Orifice for Ureterorenoscopy
- Author
-
Majid Eshghi
- Subjects
Endoscopes ,Ureteral orifice ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Endoscopy ,Equipment Design ,Dilatation ,Surgery ,Catheters, Indwelling ,Ureteral dilatation ,Humans ,Ureteral Diseases ,Medicine ,Ureteroscopy ,Ureter ,Urinary Catheterization ,business - Abstract
The history of endoscopic ureteral dilatation began before the turn of the century, and many of those older methods are still in use with the aid of updated instruments. The recent development of controlled hydraulic dilatation promises to make ureteroscopy a one-step procedure.
- Published
- 1988
50. Percutaneous (Endo) Infundibulotomy
- Author
-
Majid Eshghi, William Tuong, Joseph C. Addonizio, and Rafael Fernandez
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Percutaneous ,Caliceal diverticulum ,Stone formation ,business.industry ,Urology ,medicine.medical_treatment ,Renal parenchyma ,medicine.disease ,Surgery ,Stenosis ,Infundibular Stenosis ,Nephrostomy ,cardiovascular system ,medicine ,Stone removal ,Radiology ,business - Abstract
Infundibular stenosis often results in hydrocalix and caliceal diverticulum and stone formation. If not corrected, stenosis will lead to deterioration of the renal parenchyma. Percutaneous infundibulotomies through a nephrostomy tract were successful in 14 patients. Direct puncture into the involved calix provides the best access for stone removal and incision or dilatation of the infundibular stenosis.
- Published
- 1987
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