Anesthesia for laparoscopic gastroplasty in morbid obesity.
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Biomedical subjects
Publications and source records attributed to A B Mofti.
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The Plastibell technique is a simple, satisfactory and easily learned method of circumcision. It is important to stress the practicality of this method in the neonatal period, thus reducing both emotional trauma and financial cost of admission at a later date.
A case of traumatic paraplegia, with almost complete motor and sensory loss up to the umbilicus, who had an operation for post traumatic arachnoiditis and diagnosed as having recurrence of arachnoiditis and traumatic syringomyelia and treated by a pedicled omental onlay graft to the spinal cord, is described. The patient made a remarkable recovery and 1 year after surgery he continues to maintain excellent progress. He is now able to walk with support and is completely independent. It is suggested that chronic paraplegics should be assessed for possible arachnoiditis and traumatic syringomyelia and if detected an omental transposition be considered as one means of increasing rehabilitation potential.
Severe hypoglycaemia as a complication of excision of a phaeochromocytoma has been reported seven times in the world literature. The eighth case, reported here, is unusual for the severity of the hypoglycaemic neurological damage which persisted for 10 weeks before ultimate recovery.
The routine use of peroperative (pre-exploration) cholangiography was prospectively studied in 433 consecutive patients undergoing elective cholecystectomy. Satisfactory peroperative cholangiography was achieved in 396 patients using a C-arm image intensifier with image retention facility. Clinical indications for exploration of the common bile duct were noted for each patient but the decision for choledochotomy was determined by the cholangiographic results. Two hundred and forty-nine (63 per cent) patients had no clinical indications for duct exploration and cholangiographic findings were all normal. Of the 147 patients with positive clinical criteria, 39 (9.8%) had abnormal cholangiograms and required exploration of the common bile duct. In three patients duct exploration was negative giving a false positive rate of 0.73 per cent. The use of the image intensifier allowed dynamic study during cholangiography and optimum evaluation of the duct system. The results support the view that peroperative cholangiography could be restricted to patients with clinical indications for exploration of the common bile duct.
We report a case of Turcot's syndrome in a 20-year old man with multiple adenomatous polyps of the colon and glioblastoma multiforme. Detailed histopathological study of all 25 polyps removed from his colon confirmed the distinct morphological and numerical features of the colonic polyposis in Turcot's syndrome. Moreover, 45% of the total polyps and all polyps with a diameter exceeding 2 cm showed malignant transformation, indicating the precancerous nature of these polyps. These findings are discussed together with data obtained from a literature review of 32 histopathologically confirmed cases of Turcot's syndrome with reference to the possible heterogeneous nature of the syndrome at the present time. The current views on the relationship of Turcot's syndrome to other polyposis coli syndromes are presented.