Surgical Specialist, Urologists
19 years of experience

Accepting new patients
1200 South Ave
Ste 301
Staten Island, NY 10314
Locations and availability (4)

Education ?

Medical School Score
Georgetown University (1991)
  • Currently 2 of 4 apples

Awards & Distinctions ?

American Board of Urology
American College of Surgeons
American Medical Association
American Urological Association

Affiliations ?

Dr. Motta is affiliated with 15 hospitals.

Hospital Affilations



  • St Vincent's Midtown Hospital
    415 W 51st St, New York, NY 10019
    • Currently 4 of 4 crosses
    Top 25%
  • Staten Island University South
    375 Seguine Ave, Staten Island, NY 10309
    • Currently 3 of 4 crosses
    Top 50%
  • Staten Island University Hospital North
    475 Seaview Ave, Staten Island, NY 10305
    • Currently 3 of 4 crosses
    Top 50%
  • University Hospital of Brooklyn at Long Island Hospital
    340 Henry St, Brooklyn, NY 11201
    • Currently 2 of 4 crosses
  • SVCMC St Vincent's Hospital Richmond
    75 Vanderbilt Ave, Staten Island, NY 10304
    • Currently 2 of 4 crosses
  • Suny Downstate Mc at Lich
  • Richmond University Medical Center
    355 Bard Ave, Staten Island, NY 10310
  • Saint Vincents Catholic Medical Centers of NY Bayley Seton
  • Sisters of Charity Medical Center-Saint Vincent`s Campus
  • Staten Island University Hosp-Concord
  • Staten Island Univ HospNorth, Staten Island, Ny
  • Saint Vincent Catholic Medical Centers-Saint Vincent`s Hospital Manhattan
  • Richmond University Medical Center-Bayley Seton Campus
  • Doctors Hospital Of Staten Island Inc
  • Doctors Hospital
  • Publications & Research

    Dr. Motta has contributed to 36 publications.
    Title Seed Implant Retention Score Predicts the Risk of Prolonged Urinary Retention After Prostate Brachytherapy.
    Date April 2010
    Journal International Journal of Radiation Oncology, Biology, Physics

    To risk-stratify patients for urinary retention after prostate brachytherapy according to a novel seed implant retention score (SIRS).

    Title Outbreak of Acute Renal Failure in Panama in 2006: a Case-control Study.
    Date January 2009
    Journal Bulletin of the World Health Organization

    In September 2006, a Panamanian physician reported an unusual number of patients with unexplained acute renal failure frequently accompanied by severe neurological dysfunction. Twelve (57%) of 21 patients had died of the illness. This paper describes the investigation into the cause of the illness and the source of the outbreak.

    Title Salvage Prostate Brachytherapy for Localized Prostate Cancer Failure After External Beam Radiation Therapy.
    Date June 2008
    Journal Brachytherapy

    PURPOSE: To determine the toxicity and clinical outcome of salvage prostate brachytherapy for localized prostate cancer failure after external beam radiation therapy. METHODS AND MATERIALS: Twenty-one patients underwent (103)Pd salvage brachytherapy (median minimum peripheral dose, 90Gy) after local failure after external beam radiation (median dose, 66.6Gy) from 1/21/1998 to 4/5/2005. The median age was 72 years. Six patients had prior transurethral resection of the prostate. The median Gleason score was 7 and the median preimplant prostate-specific antigen was 3.8. Twelve patients received concurrent androgen ablation with prostate brachytherapy. Biochemical failure was defined as three consecutive rises in prostate-specific antigen scored at the call date, initiation of hormone therapy, or clinical failure. Toxicity was defined according to the National Cancer Institute common toxicity criteria and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring scheme. RESULTS: With a median followup of 36 months, the actuarial 3-year and 5-year overall survival rates were 81% and 81%, and the biochemical failure-free survival rates were 94% and 38%, respectively. There was no significant difference in biochemical failure-free survival (p=0.98) and overall survival (p=0.13) for patients who had androgen ablation. Four patients developed biochemical failure and 1 patient developed distant metastasis at 59 months from treatment. Four patients had Grade 2 genitourinary adverse events, 2 patients had Grade 1 genitourinary adverse events, and 1 patient had a Grade 2 gastrointestinal adverse event. There were no Grade 3 or higher adverse events. All three deaths were secondary to other medical comorbidities. CONCLUSIONS: Salvage prostate brachytherapy after external beam radiation failure can be safely performed with acceptable biochemical control. This treatment option should be considered for patients who have prolonged life expectancy after localized external beam radiation failure.

    Title The Position of the Mutation Within the Lmna Gene Determines the Type and Extent of Tissue Involvement in Laminopathies.
    Date July 2007
    Journal Clinical Genetics
    Title Does Flavanol Intake Influence Mortality from Nitric Oxide-dependent Processes? Ischemic Heart Disease, Stroke, Diabetes Mellitus, and Cancer in Panama.
    Date April 2007
    Journal International Journal of Medical Sciences

    Substantial data suggest that flavonoid-rich food could help prevent cardiovascular disease and cancer. Cocoa is the richest source of flavonoids, but current processing reduces the content substantially. The Kuna living in the San Blas drink a flavanol-rich cocoa as their main beverage, contributing more than 900 mg/day and thus probably have the most flavonoid-rich diet of any population. We used diagnosis on death certificates to compare cause-specific death rates from year 2000 to 2004 in mainland and the San Blas islands where only Kuna live. Our hypothesis was that if the high flavanoid intake and consequent nitric oxide system activation were important the result would be a reduction in the frequency of ischemic heart disease, stroke, diabetes mellitus, and cancer--all nitric oxide sensitive processes. There were 77,375 deaths in mainland Panama and 558 deaths in the San Blas. In mainland Panama, as anticipated, cardiovascular disease was the leading cause of death (83.4 +/- 0.70 age adjusted deaths/100,000) and cancer was second (68.4 +/- 1.6). In contrast, the rate of CVD and cancer among island-dwelling Kuna was much lower (9.2 +/- 3.1) and (4.4 +/- 4.4) respectively. Similarly deaths due to diabetes mellitus were much more common in the mainland (24.1 +/- 0.74) than in the San Blas (6.6 +/- 1.94). This comparatively lower risk among Kuna in the San Blas from the most common causes of morbidity and mortality in much of the world, possibly reflects a very high flavanol intake and sustained nitric oxide synthesis activation. However, there are many risk factors and an observational study cannot provide definitive evidence.

    Title [correlation Between Myocardial Perfusion and Coronary Angiography]
    Date February 2001
    Journal Revista Médica De Panamá

    Determining the severity of coronary heart disease is of great importance to the cardiologist. There is a very good correlation between the severity of coronary heart disease and perfusion abnormalities to the myocardium as determined by radioisotope studies. We present our experience with forty (40) cases of ischemic heart disease diagnosed with sestamibi and its correlation with the obstruction of the coronary arteries by angiography. There is good correlation between the sestamibi findings and the coronary artery angiography obstructions and our findings concur with those published in the literature, which is between 75-85%.

    Title [cardiac Insufficiency and B-blockers]
    Date February 2001
    Journal Revista Médica De Panamá

    This article summarise our experience with the Beta-Blocker in the management of congestive heart failure, which did not respond to the usual medical treatment.

    Title [rescue Angioplasty]
    Date November 1998
    Journal Revista Médica De Panamá

    This article resumes the modern management of acute myocardial infarction. It analyzes the complementary benefits of two different types of treatment: thrombolytic therapy and percutaneous transluminal angioplasty.

    Title Cystitis Glandularis.
    Date February 1998
    Journal Urology
    Title Torsion of an Indirect Hernia Sac: an Unusual Cause of Acute Scrotal Swelling in Children.
    Date October 1997
    Journal Urology

    OBJECTIVES: An indirect inguinal hernia is a common cause of inguinoscrotal swelling in young boys. We describe 3 cases of an extremely unusual entity that has a similar clinical presentation to more commonly diagnosed intrascrotal processes. METHODS: Two patients presented with acute hemiscrotal enlargement and pain, and a third patient presented with scrotal enlargement only. All patients underwent a scrotal ultrasound evaluation and subsequent inguinoscrotal exploration. RESULTS: All patients had a multiseptated peritesticular fluid-filled mass on ultrasound evaluation. Subsequent inguinoscrotal exploration revealed a torsion of the indirect hernia sac in each case. A high ligation and excision of the sac was curative. CONCLUSIONS: Torsion of a hernia sac is an extremely rare entity, and current sonographic imaging fails to clearly diagnose this unusual phenomenon. Because pediatric urologists are commonly called to evaluate a child with an acutely swollen scrotum, awareness of this diagnosis is important.

    Title [surgery of Lower Third Molars and Lesions of the Lingual Nerve]
    Date February 1997
    Journal Minerva Stomatologica

    OBJECTIVE: The authors describe a technical expedient applied during the removal of totally or partially impacted lower third molars, in order to prevent lingual nerve damage. EXPERIMENTAL ASSAY: Retrospective study. MATERIALS AND METHODS: The sample includes 1835 extractions of totally or partially impacted lower third molars, performed on 1030 patients, 493 males and 537 females, aging between 12 and 72 years. All the operations were carried out under local anaesthesia with standardization of the surgical protocol. A mucoperiosteal paramarginal flap was used in case of germectomy, whereas a mucoperiosteal marginal flap with mesial releasing incision was used in case of fully mature teeth. Ostectomy and tooth sectioning were performed using a round and fissure bur respectively, assembled on a straight low-speed handpiece and under irrigation with sterile saline. RESULTS: The authors reported only one case of transient lingual nerve paresthesia (0.05%) which occurred in a 19-years old female presenting a totally impacted third molar mesial-lingual inclination. Symptoms disappeared spontaneously one week postoperatively. Therefore the overall incidence of permanent nerve damage was equal to 0%. CONCLUSIONS: The data reported in literature show a lingual nerve lesion incidence ranging between 0% and 22%. With this simple surgical expedient the incidence of permanent lingual damage was 0%. Thus, it is the authors' opinion that this simple expedient should be applied in all cases of impacted third molar removal.

    Title The Accuracy of Transrectal Ultrasound Prostate Volume Estimation: Clinical Correlations.
    Date February 1997
    Journal Journal of Clinical Ultrasound : Jcu

    Sonographic estimates of prostate volume have been applied to the diagnosis and management of prostate cancer. However, we have observed wide variation between transrectal sonographic estimates of prostate volume (TRUS-V) and the corresponding volumes of unfixed radical prostatectomy specimens (P-V). Because TRUS-V may influence the management of men with prostate disease, the relationship between TRUS-V and P-V was characterized for 100 consecutive men undergoing a radical retropubic prostatectomy (RRP). For the entire cohort, TRUS-V (35.9 +/- 16.9 mL) underestimated P-V (45.4 +/- 22.9 mL, p < .01). Mean signed percentage error between TRUS-V and P-V was -16 +/- 32%. The relationship of TRUS-V to P-V was volume dependent (p < .001). For volumes (P-V) < 30 mL, TRUS-V overestimated P-V. For volumes (P-V) > 30 mL. TRUS-V increasingly underestimated P-V. In summary, transrectal ultrasound estimates of prostate volumes differ significantly from the volume of unfixed RRP specimens. The direction and magnitude of TRUS-V error is volume dependent. Applied clinically, treatment paradigms employing prostate-volume-dependent management algorithms derived from nonuniform methods of volume estimation may not accurately reflect volume nomograms derived from uniform methods of measurement, and thus alter patient management.

    Title [transesophageal Echocardiography in Panamá. Experience in 30 Months]
    Date December 1996
    Journal Revista Médica De Panamá

    47 transesophageal echocardiograms (TEE) were performed on 43 patients (27 men and 20 women) in 30 months. The average age was 52.1 +/- 24.3 years. The most frequent indications for the procedure were: search for the source of emboli in 15 patients, suspected endocarditis and valvulopathies in 11. The main findings were intracavitary thrombi in 9 and vegetations in 8. The findings on TEE changed the medical management in 22 patients, confirmed suspected diagnosis in 15, and added nothing new in 10. Hypotension occurred in only one patient and resolved when the transducer was withdrawn. Comparing their results with those found in the literature the authors found that the indications were similar. TEE is an easy, safe and trustworthy study in selected patients.

    Title [complex and Multiple Vessel Angioplasty]
    Date August 1996
    Journal Revista Médica De Panamá

    The authors present the clinical history of a 66 year old woman with a previous anterior myocardial infarction and periinfarct ischemia as well as ischemia in another area not related to the scar (in the posterolateral region of the left ventricle) in whom they successfully performed percutaneous coronary angioplasty of the anterior descending and circumflex arteries since the patient was not a candidate for surgical revascularization because of her clinical condition.

    Title Psa Divergence. A New Parameter for the Accurate Longitudinal Assessment of Prostatic Disease.
    Date July 1996
    Journal American Journal of Clinical Oncology

    Prostate-specific antigen (PSA) and the various parameters derived utilizing this marker have increased our ability to diagnose early prostatic disease; however, their accuracy in identifying the etiology of the disease remains somewhat limited. We propose a new PSA derivative, termed "PSA divergence" (PSADI), defined as the change in serum PSA over time (years) divided by the change in prostatic volume over time (years), to more accurately distinguish benign, premalignant, and malignant prostatic diseases. In this study, we evaluated 160 subjects with a PSA >4.0 ng/ml who were found by transrectal ultrasound-guided biopsy (TRUS) to have either benign prostatic hyperplasia or prostatic intraepithelial neoplasia. These men were followed at 6 or 12 months with serial PSA, digital rectal exam (DRE), and TRUS with rebiopsy. Data analysis demonstrated a statistically significant (p < 0.05) correlation between PSADI and each final pathologic outcome, suggesting that PSADI is useful in distinguishing among intraepithelial neoplasia and benign and malignant prostatic disease.

    Title Evaluation of Asymptomatic Microhematuria.
    Date November 1995
    Journal Urology

    OBJECTIVES. The purpose of this study was to evaluate a comprehensive urine cytodiagnostic assay to assist in localizing the site of origin and the etiology of asymptomatic microhematuria. This analysis, which assesses various qualitative and quantitative aspects of the voided urine, is compared simultaneously with controls obtained from the established routine urologic evaluation. METHODS. One hundred consecutive subjects who presented solely for the evaluation of asymptomatic microhematuria were evaluated by the established routine urologic evaluation and a refined urine cytodiagnostic assay. For the purpose of this study, only calculi and neoplasms were considered significant findings. RESULTS. The incidence of significant urologic disease was 13% (3 renal neoplasms, 2 urothelial bladder carcinomas, and 8 urinary calculi). The refined urine cytodiagnostic assay identified both uroepithelial vesical neoplasms, 7 of the 8 urinary calculi, and none of the 3 renal neoplasms. The presence of dysmorphic urinary red blood cells (RBCs) and RBC casts was strongly suggestive of renal parenchymal bleeding. Overall, 43 of 44 subjects (98%) with dysmorphic RBCs and RBC casts failed to demonstrate any significant urologic etiology. CONCLUSIONS. These preliminary results suggest that the refined cytodiagnostic urine assay may be helpful in distinguishing whether a given patient's microhematuria is of a significant urologic or a renal parenchymal cause. The addition of this specialized urinalysis may prove a useful adjunct in improving the diagnostic yield in patients with asymptomatic microhematuria.

    Title [myocardial Perfusion Studies During Exertion and Rest Performed at the Hospital Militar Gorgas (hmg)]
    Date June 1995
    Journal Revista Médica De Panamá

    We report the experience at Gorgas Army Hospital with myocardial perfusion studies by single-photon emission tomography. We describe the technique, the specificity and sensitivity, and its use in the diagnosis, evaluation of extension and prognosis of coronary artery disease.

    Title Congenital Renal Arteriovenous Malformation in Pregnancy Presenting with Hypertension.
    Date January 1995
    Journal Urology

    Congenital renal arteriovenous malformations (AVMs) are rare, with approximately 50 cases reported in the literature. Typically, they are small (1 to 2 cm) and the majority present with hematuria and symptoms and signs of congestive heart failure. Review of the literature revealed only 4 cases reported in pregnant patients and their presentation was with hematuria and rupture of the AVM. We present a case of a young female patient with a 6 cm congenital renal AVM who was otherwise asymptomatic until her first pregnancy, when she developed and presented with symptoms of hypertension and an abdominal bruit. Her symptoms persisted postpartum. Hematuria and rupture of the AVMs were not part of her clinical course. A partial nephrectomy was curative.

    Title [radioventriculography During Exercise in the Diagnosis and Management of Patients with Coronary Disease]
    Date November 1991
    Journal Revista Médica De Panamá

    We describe the use of exercise radionucleide ventriculography in patients with different probabilities of suffering from ischemic coronary disease. The majority of patients with low probability demonstrated an increase of the ejection fraction and the ones with a high probability a reduction. We describe the utility of this test in the diagnosis, evaluation of the severity and management of patients with coronary disease.

    Title [intravenous Thrombolytic Therapy in Acute Infarct of the Myocardium]
    Date July 1989
    Journal Revista Médica De Panamá

    Treatment of acute myocardial infarction with plasminogen activators represents a significant advance in cardiovascular pharmacotherapy. This paper describes the first local treatment experience of myocardial infarction in two patients with intravenous thrombolytic agents. The indications and general aspects of thrombolytic treatment are discussed. Thrombolytic therapy has become standard treatment for some patients with acute myocardial infarction.

    Title [familial Dilated Cardiomyopathy in Panama]
    Date May 1989
    Journal Revista Médica De Panamá
    Title Obstructive Sleep Apnea and Cardiac Index.
    Date April 1986
    Journal Chest

    Seventeen men (age range, 21 to 58 years) with severe obstructive sleep apnea syndrome (OSAS) documented by nocturnal polysomnography underwent hemodynamic investigations during sleep. We studied the evolution of the cardiac index during apneic events in both NREM and REM sleep using the thermodilution technique. Regardless of the patient's age, the sleep state, or the mechanism inducing the OSAS, the cardiac index decreased significantly from baseline during an apneic event and increased significantly from baseline at the resumption of ventilation.

    Title Cardiac Dysfunction During Sleep.
    Date February 1986
    Journal Annals of Clinical Research
    Title Sinus Arrest During Rem Sleep in Young Adults.
    Date November 1984
    Journal The New England Journal of Medicine

    Four apparently healthy young adults with vague chest symptoms during the day, two of whom had infrequent syncope while ambulatory at night, had periods of asystole up to nine seconds in duration occurring repeatedly during rapid-eye-movement (REM) sleep. Extensive evaluations, including electrophysiologic studies in two patients, were normal. It is therefore suggested that the underlying pathophysiology involved autonomic dysfunction. REM sleep-related sinus arrests such as these, which may occur in apparently healthy subjects but are undetected, may explain some cases of sudden, unexpected death during sleep. Polygraphic monitoring during sleep may be helpful in delineating the pathophysiology of the sleep-related arrhythmia in persons with daytime cardiac arrhythmias thought to be secondary to abnormal vagal tone. The possibility of nocturnal asystole should be considered in patients such as those described here.

    Title B5 and B15 Associated with Progressive Marek's Disease, Rous Sarcoma, and Avian Leukosis Virus-induced Tumors in Inbred 15i4 Chickens.
    Date August 1983
    Journal Poultry Science

    RPRL 15I4 inbred chickens are nearly histocompatible except for the B5 and B15 haplotypes that determine the major transplantation antigens. B5B5 and B15B15 15I4 chickens were equally and highly susceptible to tumors induced by Marek's disease, Rous sarcoma, or avian leukosis viruses (ALV), suggesting both of these haplotypes may determine a general influence leading to tumor development. The 15I4 birds were highly susceptible to erythroblastosis, and most developed immunological tolerance to the virus after ALV infection.

    Title Tests of Association of Lymphocyte Alloantigen Genotypes with Resistance to Viral Oncogenesis in Chickens. 1. Marek's Disease in F7 Progeny Derived from 6(3) X 15(1) Crosses.
    Date April 1983
    Journal Poultry Science

    Marek's disease (MD)-susceptible progeny of the B5B5 genotype from the F7 generation derived from crosses of Regional Poultry Research Laboratory inbred lines 6(3) and 15(1) were tested for variation in MD resistance associated with the T lymphocyte antigen loci Ly-4 and Th-1. The four double homozygous genotypic classes of Ly-4 and Th-1 were tested in a 2 X 2 design. The Ly-4bb/Th-1aa chickens were significantly more resistant to MD oncogenesis than the other three genotypes. Thus, resistance within B5B5 genotypes appears to be associated with genetic interaction between two T cell antigen loci, which are not linked with the B complex.

    Title Allograft and Mixed Lymphocyte Response Studies in 6(3) X 15(1) F6 Chickens.
    Date September 1982
    Journal Poultry Science
    Title Skin-graft Histocompatibility Within Regional Poultry Research Laboratory Inbred Chicken Lines.
    Date August 1982
    Journal Poultry Science

    Skin grafts were exchanged between specific-pathogen-free chicks within the Regional Poultry Research Laboratory (RPRL) inbred lines that are characterized for retrovirus susceptibility and immunogenetic traits. Lines 61 and 63 were histocompatible whereas lines 15I4 and 15I5 were nearly histocompatible. The RPRL Line 7(2) is only histocompatible within families at present, and line 100 has considerable heterogeneity for minor histoantigens. Reaseheath Line C (RH-C) has been established at the RPRL and its histocompatible. Numerous males in lines 6(1), 6(3), 15I4, and RH-C are able to reject female grafts containing the female-specific histoantigen. Two Ea-B alleles in 15I4 previously detected by blood-typing determined rapid skin graft rejection.

    Title B-haplotype Influence on Marek's Disease, Rous Sarcoma, and Lymphoid Leukosis Virus-induced Tumors in Chickens.
    Date October 1981
    Journal Poultry Science

    Experiments were conducted to establish whether B-haplotype genes that determine resistance to RSV-induced tumors would also influence resistance to Marek's disease and lymphoid leukosis. Matings of line 6(3) x 15(1) F3 or F4 breeders segregating for the Ea-B locus antigens that are markers for B2 and B5 haplotypes of the B major histocompatibility complex were made to produce B2B2, B2B5, and B5B5 chicks. The chicks were infected with a standard inoculum of one of the three tumor viruses in separate experiments. The B2 haplotype from 6(3) conveyed greater resistance to tumors induced by all three viruses than the B5 from 15(1) chickens. This finding suggests that some gene(s) in the B-haplotype may determine a general ability to resist tumor formation or cause tumor regression.

    Title Obstructive Sleep Apnea Syndrome and Tracheostomy. Long-term Follow-up Experience.
    Date August 1981
    Journal Archives of Internal Medicine

    Obstructive sleep apnea syndrome (OSAS), a disabling disorder that leads to life-threatening cardiorespiratory events during sleep, has been treated by tracheostomy. This article reports long-term follow-up data of 50 patients who have undergone this procedure, and the indications for surgery are summarized. Surgery may result in secondary local and general acute and subacute complications, but, on a long-term basis, patients were completely relieved of clinical symptoms, returned to full activity, and adapted normally to social and familial life. Temporary closure of the tracheostomy during sleep led to recurrence of obstructive sleep apnea.

    Title Chronic Obstructive Airflow Disease and Sleep Studies.
    Date November 1980
    Journal The American Review of Respiratory Disease

    Twenty-six patients with chronic obstructive airflow disease (23 also complained of excessive daytime somnolence) were monitored during sleep, using noninvasive techniques, for evaluation of respiratory and sleep variables. Ten of the 26 had a second more extensive evaluation, including measurement of endoesphageal pressure; 5 underwent a study of nocturnal hemodynamics, with measurement of systemic and pulmonary pressures; 5 received O2 in air during sleep under controlled conditions. Eight of the studied patients underwent tracheostomy and were restudied postoperatively. Both sleep stage and type of abnormal respiratory event during sleep affected oxygenation levels. A mean of 92% of all abnormal respiratory events during sleep contained an obstructive component. Apneic events may affect systemic and pulmonary arterial pressures during sleep. Administration of O2 in air may, in some cases, be detrimental to the sleeping patient. Tracheostomy unexpectedly improved the daytime, awake blood gas readings of somee patients. The mechanism of daytime somnolence was not elucidated in all cases.

    Title Respiratory and Hemodynamic Study During Wakefulness and Sleep in Myotonic Dystrophy.
    Date December 1979
    Journal Sleep

    Six young male patients with grade I (mild) myotonic dystrophy and a complaint of excessive daytime sleepiness were studied during wakefulness and sleep. Pulmonary function tests during wakefulness showed evidence of mild abnormality related to respiratory muscle weakness. During sleep, some patients developed a sleep apnea syndrome with high sleep Apnea Indices. There was no relation between hypoxic and hypercapnic ventilatory responses during wakefulness and sleep Apnea Indices. But hypoxemia and hypercapnia worsened considerably during REM sleep. Myotonic dystrophy patients with sleep apnea presented increased pulmonary and systemic arterial pressures during sleep. It was also during sleep that arrhythmias were observed.

    Title Cardiac Abnormalities in Myotonic Dystrophy. Electrophysiologic and Histopathologic Studies.
    Date October 1979
    Journal The American Journal of Medicine

    Eight young adult male patients with myotonic dystrophy, mean age 26 years, underwent 24-hour Holter electrocardiographic monitoring and intracardiac electrophysiologic study. Right ventricular endomyocardial biopsies were performed at the end of the electrophysiologic study in five of them. The atrial to His[A-H] interval was 155 msec in one case and less than or equal to 55 msec in all patients. Twenty-four hour Holter electrocardiographic monitoring demonstrated more than 4 premature ventricular contractions per minute in two patients and marked cyclical sinus arrhythmia during sleep in two others. Electron microscopic analysis of the endomyocardial biopsy specimens disclosed no prominent sarcoplasmic reticulum abnormalities but prominent I bands compared to previously obtained controls. Myofibrillar degeneration was seen in all cases and was associated with abnormal mitochondria in two. Cardiac abnormalities can be detected very early in the evolution of myotonic dystrophy, even prior to the onset of cardiac symptoms. The reported abnormalities appear closely related to the pathologic process affecting other skeletal muscles.

    Title Tracheostomy and Hemodynamic Changes in Sleep-inducing Apnea.
    Date November 1978
    Journal Annals of Internal Medicine

    Because pulmonary hypertension and systemic hypertension occur during sleep-induced obstructive apnea, six patients underwent overnight hemodynamic monitoring before and after tracheostomy. Variables studied included heart rate, pulmonary artery pressure, femoral artery pressure, and arterial oxygen tension (Po2). After tracheostomy, significant reductions were noted during sleep in mean pulmonary artery pressure from 45 +/- 6 mm Hg (mean +/- SEM) to 22 +/- 2 mm Hg (P less than 0.05) and in mean femoral artery pressure from 137 +/- 6 mm Hg to 97 +/- 3 mm Hg (P less than 0.005). There was also a significant increase for the group in arterial Po2 recorded during the apneic episodes from 38 +/- 3 mm Hg before tracheostomy to 71 +/- 2 mm Hg (P less than 0.001) after tracheostomy. We conclude that tracheostomy improves the hemodynamic abnormalities and hypoxemia that occur during sleep in patients with sleep-induced obstructive apnea.

    Title Pericardial Effusions in Patients with End-stage Renal Disease.
    Date June 1978
    Journal British Heart Journal

    Echocardiography has greatly increased the accurate recognition of pericardial effusion. Echocardiograms were performed prospectively on the total group of 35 stable asymptomatic patients on chronic haemodialysis to determine the incidence of pericardial effusion. Effusions were shown in 11 per cent (4/35); only 6 per cent (2/35) were estimated as greater than 100 ml. For comparison, records were reviewed retrospectively from 41 haemodialysis patients referred during a 27-month period for echocardiographic assessment of suspected pericardial effusion. These 41 patients came from a total group of 108 patients treated with chronic dialysis over this interval. Of 41 examined, 21 (51%) or 21 of 108 (19%) of the population at risk had an effusion. Of 21 with echocardiographic effusions, 15 (71%), or 15 of 41 (37%) of those with clinically suspected effusion, had more than 100 ml fluid. Gross (greater than 100 ml) pericardial effusions are infrequent in stable, asymptomatic patients with end-stage renal disease. When clinical findings suggest pericardial disease, the echocardiographic demonstration of over 100 ml pericardial fluid is indicative of new effusion, rather than coincidental pre-existing effusion.

    Title Development and Validation of a 3d Clinostat for the Study of Cells During Microgravity Simulation.
    Journal Conference Proceedings : ... Annual International Conference of the Ieee Engineering in Medicine and Biology Society. Ieee Engineering in Medicine and Biology Society. Conference

    The clinostat was originally used to find out why plant roots appear to grow predominantly toward the center of the Earth. Over the last 2-3 decades, slow- and fast-rotating 2D and 3D clinostats have been used to assess cellular adaptation to this environment. A cell culture is placed in a spin module of the clinostat platform and its rotation is set empirically (2-3 rpm). The machine is then allowed to run for a specified period (hours to days) after which the cultures are removed and assayed for specific properties, such as cell growth, size and shape, distribution of receptors, integrity of the cytoskeleton or gene expression. A 3D clinostat was developed by the Microgravity Laboratory/IPCT-PUCRS group and validated by the Stem Cell Group of Kingston University London, which used 4 different types of human cancer cells and cord blood stem cells (CBSC). After rotation for 19h at 37degC, 5%CO2 humidified atmosphere, the 3D clinostat significantly improved proliferation potential of all tested cell populations when compared to static cultures. After only 5 days, high definition microscopic analysis revealed that all CBSC adhered and expanded onto the BDtrade 3D collagen composite scaffolds, and cross-developed into hepatocyte-like cells upon stimulation.

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