Ahmed El-assmy - Academia.edu (original) (raw)

Papers by Ahmed El-assmy

Annals of urologic oncology, Oct 4, 2023

Current Urology, Aug 2, 2022

Urologic Oncology-seminars and Original Investigations, May 1, 2022

About 70% of newly diagnosed cases of bladder cancer are low-stage, low-grade, non muscleinvasive... more About 70% of newly diagnosed cases of bladder cancer are low-stage, low-grade, non muscleinvasive. Standard treatment is transurethral resection. About 60% of the tumors will recur, however, and in part progress to become invasive. Therefore, surveillance cystoscopy is performed after resection. However, in the USA and Europe alone, about 54 000 new patients per year undergo repeated cystoscopies over several years, who do not experience recurrence. Analysing in a pilot study resected tumors from patients with (n = 19) and without local recurrence (n = 6) after a period of 5 years by means of an antibody microarray that targeted 724 cancer-related proteins, we identified 255 proteins with significantly differential abundance. Most are involved in the regulation and execution of apoptosis and cell proliferation. A multivariate classifier was constructed based on 20 proteins. It facilitates the prediction of recurrence with a sensitivity of 80% and a specificity of 100%. As a measure of overall accuracy, the area under the curve value was found to be 91%. After validation in additional sample cohorts with a similarly long follow-up, such a signature could support decision making about the stringency of surveillance or even different treatment options.

$Research paper thumbnail of Could the bulbar urethral end location on the cystourethrogram predict the outcome after posterior urethroplasty for pelvic fracture urethral injury?$

Molecular Biology Reports

OBJECTIVES To test the chemo-preventative effects of omega-3 against bladder cancer (BC) inductio... more OBJECTIVES To test the chemo-preventative effects of omega-3 against bladder cancer (BC) induction in a rat model and its potential antineoplastic mechanisms. MATERIAL AND METHODS Ninety male Fisher rats were divided into three groups during a 22-week protocol: group 1 (control), group 2 (Placebo + N-butyl-N-4- hydroxybutyl nitrosamine (BBN) for induction of BC and group 3 received omega-3 (1200 mg/kg/day) + BBN. At the end, blood samples and bladder tissues were collected and checked for the presence of malignancy, markers of angiogenesis (VEGF relative gene expression), inflammation (IL-6), proliferation (KI-67 expressions), oxidative stress (serum MDA and serum SOD) and epigenetic control (miRNA-145 level). RESULTS At the end of the study, 60% and 86.6% rats survived in group 2 and 3 with significant weight loss among rats in group 2 when compared with other groups. In group 2, all rats developed visible bladder lesions of which five and 13 developed squamous cell carcinoma (SCC) and transitional cell carcinoma (TCC). In omega3-treated group, only one developed low grade SCC and one developed high grade non- invasive TCC. Bladders from omega-3-treated rats showed lower expression ofKI-67 (p < 0.05), VEGF (p < 0.001) and IL-6 (p < 0.001) and significant higher expression of mi-RNA (p < 0.001). Also, omega-3-treated group showed statistically significant lower MDA level (p < 0.001). CONCLUSION Omega-3 inhibits bladder tumor growth in the BBN-induced BC rat model, due to anti-inflammatory, antioxidant, anti-proliferative, and anti-angiogenic properties together with epigenetic control.

BMC Medical Genomics, 2017

Background: One of the fundamental challenges in cancer is to detect the regulators of gene expre... more Background: One of the fundamental challenges in cancer is to detect the regulators of gene expression changes during cancer progression. Through transcriptional silencing of critical cancer-related genes, epigenetic change such as DNA methylation plays a crucial role in cancer. In addition, miRNA, another major component of epigenome, is also a regulator at the post-transcriptional levels that modulate transcriptome changes. However, a mechanistic role of synergistic interactions between DNA methylation and miRNA as epigenetic regulators on transcriptomic changes and its association with clinical outcomes such as survival have remained largely unexplored in cancer. Methods: In this study, we propose an integrative framework to identify epigenetic interactions between methylation and miRNA associated with transcriptomic changes. To test the utility of the proposed framework, the bladder cancer data set, including DNA methylation, miRNA expression, and gene expression data, from The Cancer Genome Atlas (TCGA) was analyzed for this study. Results: First, we found 120 genes associated with interactions between the two epigenomic components. Then, 11 significant epigenetic interactions between miRNA and methylation, which target E2F3, CCND1, UTP6, CDADC1, SLC35E3, METRNL, TPCN2, NACC2, VGLL4, and PTEN, were found to be associated with survival. To this end, exploration of TCGA bladder cancer data identified epigenetic interactions that are associated with survival as potential prognostic markers in bladder cancer. Conclusions: Given the importance and prevalence of these interactions of epigenetic events in bladder cancer it is timely to understand further how different epigenetic components interact and influence each other.

Journal of Magnetic Resonance Imaging, 2012

Purpose: To retrospectively assess the value of magnetic resonance imaging (MRI) in the diagnosis... more Purpose: To retrospectively assess the value of magnetic resonance imaging (MRI) in the diagnosis of vesicouterine fistula (VUF). Materials and Methods: Between January 2003 and January 2011, 12 patients with a diagnosis of VUF were surgically managed at our center; among them, eight patients had MRI among their preoperative radiological investigations and those were included in our study. The clinical presentation, radiological investigations, and surgical findings of the patients were reviewed. Results: The mean age of the patients was 31 years. Seven of the eight patients had complaints of cyclic hematuria and the remaining patient complained of urinary leakage through the vagina. The etiology of VUF was cesarean section in all patients. The preoperative radiological investigations included conventional cystography in five patients, intravenous urography in two, computed tomography (CT) urography in two, and MRI in eight. The sensitivities of diagnosis for these investigations were 40%, 0%, 50%, and 100%, respectively. Conclusion: In our small retrospective series, pelvic MRI was reliable and sensitive for diagnosis of VUF. It should be considered in the work-up of patients with suspected VUF.

The Journal of Urology, 2017

prospective cohort study in patients with low-risk NMIBC selected for a monitoring program (Bladd... more prospective cohort study in patients with low-risk NMIBC selected for a monitoring program (Bladder Cancer Italian Active Surveillance-BIAS project). METHODS: This is an observational prospective longitudinal study (EC approval: ICH/1390/C780) enrolling patients, aged ! 18 yrs, with a history of low-grade pTa-pT1a tumours with recurrence. Inclusion criteria were: negative cytology (three consecutive negative samples), 5 endoscopic lesions, diameter 10 mm and no carcinoma in situ (CIS) or persistent gross haematuria. Cases were followed-up by urine cytology and in-office flexible cystoscopy at intervals of four months in the first year, and then every six months annually. The primary outcome was to test the adherence to monitoring (AS) defining a failure as any progression in number/dimension/positive cytology/signs (gross haematuria persistent) or any further intervention (resection or electrofulguration). Secondary end-point consisted in the assessment of pathological progression defined as upgrading and up-staging at failure. A descriptive statistical analysis with qualitative variables presented by frequency distribution and the quantitative variables by the mean or median with AE SD/IQR was applied. RESULTS: Overall, 99 patients (mean age 72.1 AE 14.7 years) underwent 120 AS events from June 2008 to September 2016. The median follow-up was 44 months (IQR:51). The median time between first TURBT and recruitment to AS was 22.5 mo (IQR:12.5). The median number of TURBT before AS entry was 2 (r. 1-4). The pathological characteristics at entry showed pTa and pT1a in 80 and 19 patients respectively; 69 had G1 (69.7%) and 30 G2 (30.3%). Patients remained under AS for a median time of 21.3 months (IQR:21.5); 5 patients were lost to FU due to deaths, which were not related to bladder cancer. A failure was observed in 40 (40.4%) patients, corresponding to 45 events (37.5%). Within failure events, 17 (37.8%) were due to dimensions, 10 (22.2%) to number and 3 to contemporary dimension and number increase. Gross haematuria was the cause of failure in 10 events and positive cytology in 5. No patient experienced stage and grade progression. Eleven failures presented as pT1a and 31 as pTa; 6 failures were classified as G3, 9 G2 and 27 G1. In three patients the TURBT did not reveal neoplasia in pathological samples. One (1%) patient showed CIS. The overall adherence to controls was 95%. CONCLUSIONS: Current findings seem to support AS for NMIBC as a reasonable option in patients with small, low stage, lowgrade recurrent papillary bladder cancer after TURBT. Although the current population is one of the largest with a long-term follow-up, further multicentre studies under randomisation criteria are mandatory in order to include AS in our daily practice.

The Journal of Urology, Apr 1, 2007

CONCLUSIONS: Patients with nephrocalcinosis often have significant calyceal stone burdens that ar... more CONCLUSIONS: Patients with nephrocalcinosis often have significant calyceal stone burdens that are underestimated by radiographic imaging. The amount of nephrocalcinosis appears to correlate directly with the severity of disease and inversely with renal function. Patients in the earlier stages of renal disease may benefit significantly from PNL.

Journal of Urology

INTRODUCTION AND OBJECTIVE:To evaluate the prognostic role of PD1/PDL1 expression in exclusively ... more INTRODUCTION AND OBJECTIVE:To evaluate the prognostic role of PD1/PDL1 expression in exclusively high risk T1G3 patients with non-muscle-invasive bladder cancer (NMIBC) as predictors of BCG respons...

Objective: This study was conducted to compare the results of community based screening program f... more Objective: This study was conducted to compare the results of community based screening program for prostate cancer with case finding among urologic patients. Patients and Methods: Two programs for prostate cancer detection were conducted based on PSA assay (cutoff value 4ng/ml) and DRE for men aged 50 to 75 years. The first one included 833 urologic patients (group 1) and the second included 882 men who responded to a campaign for early detection of prostatic diseases (group 2). Diagnosis of prostatic adenocarcinoma depends on ultrasound guided six-core prostatic biopsies. Results: In group 1, 154 patients were biopsied (147 due to high PSA ± suspicious DRE and 7 due to suspicious DRE alone). Prostate cancer was diagnosed in 36 patients (4.3%). Organ confined cancer was detected in 41.7% of them (15 patients). In group 2, 75 men were biopsied (69 for high PSA± suspicious DRE and 6 for suspicious DRE alone).The cancer detection rate was 2.2% (19 patients) and the rate of organ confi...

The World Journal of Men's Health

Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performe... more Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods: Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results: Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/ uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available. Conclusions: Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.

Journal of Urology, 2020

INTRODUCTION AND OBJECTIVE:to compare the outcome of shock wave lithotripsy (SWL) for upper lumba... more INTRODUCTION AND OBJECTIVE:to compare the outcome of shock wave lithotripsy (SWL) for upper lumbar ureteric stones using the alternating bidirectional approach versus the standard approach during t...

BJU International, 2020

ObjectivesTo study the efficacy of low‐energy shock wave therapy (LESW) on enhancing intravesical... more ObjectivesTo study the efficacy of low‐energy shock wave therapy (LESW) on enhancing intravesical epirubicin (EPI) delivery in a rat model of bladder cancer (BCa).Materials and MethodsA total of 100 female Fischer rats were randomly allocated into five groups: control; BCa; LESW; EPI; and EPI plus LESW. After BCa induction by N‐butyl‐N‐(4‐hydroxybutyl)nitrosamine, EPI (0.6 mg/0.3 mL of EPI diluted in 0.3 mL saline) or saline (0.6 mL) was administered and retained in the bladders for 1 h with or without LESW treatment (300 pulses at 0.12 mJ/mm2). This was repeated weekly for 6 weeks. Survival was then calculated, rats were weighed and their bladders were harvested for bladder/body ratio estimation, histopathological examination, p53 immunostaining, miR‐210, hypoxia‐inducible factor (HIF)‐1α, tumour necrosis factor (TNF)‐α and interleukin (IL)‐6 relative gene expression and fluorescence spectrophotometric drug quantification. Heart and blood samples were also collected for assessment ...

Journal of Urology, 2019

Group 5: SCT rats þ FF 0.18 mg/kg/d þ 72-h wash-out period; Group 6: SCT rats þ FF 0.12 mg/kg/d þ... more Group 5: SCT rats þ FF 0.18 mg/kg/d þ 72-h wash-out period; Group 6: SCT rats þ FF 0.12 mg/kg/d þ 72-h wash-out period. SCT was performed at T10. FF was continuously administered from post-op day 1. RT-PCR and immunofluorescence staining was done to investigate the presence and distribution of the receptors in the bladder. The variation of expression of the muscarinic receptors (M1 to M5) between each study group was evaluated by qPCR with specific sets of primers. Comparisons between groups were conducted using a Single Factor ANOVA and two-way T-tests. RESULTS: RT-PCR demonstrated that all 5 muscarinic receptors were present in the bladder tissue (Fig 1A). Immunofluorescence revealed the presence of the 5 subtypes of muscarinic receptors in the urothelial cells, while smooth muscle cell bundles only express M2 and M3 in their periphery (Fig 1B). Previously, immunoblotting only displayed changes in the levels of receptors M2 and M3. Similarly, analysis of M2 and M3 receptors from qPCR data indicate a statistical significance (p<0.05) in variation of expression in study groups relative to control and SCT rats (Fig 1C). CONCLUSIONS: Early FF administration in a SCT rat model increases the expression of M2 muscarinic receptors in the bladder. This relative increase, along with previous results, could explain the cystometric changes previously described by early administration of FF in our model. These results combined with our recent findings that ECS induces e896