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Biomedical subjects

A Eid

Publications and source records attributed to A Eid.

At least 19 recordsLinked to original sources
PubMed1998

Cavoatrial shunt: a graft salvage procedure for suprahepatic caval anastomosis obstruction after liver transplantation.

A liver transplant recipient developed the Budd-Chiari syndrome because of an obstruction of the suprahepatic inferior vena cava anastomosis. Percutaneous balloon dilatation angioplasty was not feasible. On exploration, dense retrohepatic fibrotic reaction was observed. The patient underwent successful retrohepatic cavoatrial shunt placement by means of a 16-mm, ring-enforced polytetrafluoroethylene graft. We conclude that this shunt should be considered an additional graft salvage procedure for this complication.

Arteriovenous Shunt, Surgical↗
PubMed1998

Reconstruction of replaced right hepatic artery, to implant a single-catheter port for intra-arterial hepatic chemotherapy.

Intra-arterial hepatic chemotherapy using an implantable subcutaneous port with a catheter inserted into the gastroduodenal artery is an acceptable treatment for patients with isolated, nonresectable liver metastases from colorectal cancer. Because of the common variations of hepatic arterial anatomy occurring in about one-half of the patients, this technique will result in complete perfusion of both hepatic lobes only in those with "classical" arterial anatomy (Michels type I). Many techniques have been described in these situations, usually using a dual-catheter port with the attendant risk of hepatic misperfusion and arterial thrombosis. We herein describe an alternative technique applicable to patients with a right hepatic artery arising from the superior mesenteric artery. In this technique the right hepatic artery is anastomosed end-to-end with the gastroduodenal artery, followed by implantation of a single-catheter port that is inserted into the splenic artery.

Adult↗
PubMed1997

Salivary gland transplantation: a canine model.

Impaired salivary function with resultant severe dryness of the mouth, or xerostomia, may occur in association with a variety of systemic disorders or therapies. No adequate treatment exists for this debilitating condition, which impedes normal oral function, in particular alimentation and phonation. This study explores the feasibility of salivary gland autotransplantation, using a canine model. A salivary gland with its duct and surrounding blood vessels still attached was excised and reimplanted in the dog's thigh by anastomosing the graft's blood vessels to the femoral artery and vein. The duct was sutured to an artificial orifice cut in the thigh's skin, from which the saliva was collected. Salivary secretion was induced by a single intravenous bolus of pilocarpine (5 mg). Preoperative (normal) salivation was measured by collecting saliva from the gland in situ. Periodic functional studies showed normal saliva production during the first month after grafting, after which the salivary flow was reduced by 35% over the next 2 months. This reduction was interpreted as a sign of disuse atrophy resulting from the lack of autonomic innervation. To overcome this impediment, oral pilocarpine (5 mg/day) was administered to the recipient dog, after which normal levels of saliva were excreted through the graft during the 3-month follow-up period. The quality of the graft saliva was assessed by its protein and electrolyte levels, which showed close to normal values.

Animals↗
PubMed1997

Pancreaticogastrostomy after pancreatoduodenectomy. A retrospective study of 28 patients.

OBJECTIVE: To attempt to reduce the frequency and severity of postoperative anastomotic leakage from pancreaticojejunostomy in patients undergoing pancreatoduodenectomy. DESIGN: Retrospective case series. SETTING: Tertiary referral center, department of general surgery, in the 31-month period between April 1, 1993, and November 30, 1995. PATIENTS AND INTERVENTION: Twenty-eight patients underwent pancreatoduodenectomy with pancreaticogastrostomy. Indications for surgery included carcinoma of the pancreas (n = 14), carcinoma of the ampulla of Vater (n = 8), distal cholangiocarcinoma (n = 3), duodenal carcinoma (n = 1), an islet cell tumor (n = 1), and cystadenoma of the pancreas (n = 1). The median patient age was 62 years (range, 34-76 years). The median duration of surgery was 6.75 hours (range, 4-12 hours). MAIN OUTCOME MEASURES: An anastomotic leak was defined as a recovery of more than 50 mL/d of amylase-rich fluid from the drains (> 3 times the normal plasma levels) on or after the seventh postoperative day. RESULTS: An anastomotic leak that lasted between 7 and 14 days developed in 4 patients (14.3%). A pancreatic leak led to no major morbidity. In all cases, leakage was treated by temporary restriction of oral intake and nasogastric drainage. An intra-abdominal collection did not develop in any of these 4 patients. No patient required another surgical procedure for a pancreatic fistula or abdominal collection. One patient (3.6%) died postoperatively. The median duration of the postoperative hospital stay was 20 days (range, 12-43 days), and all patients were discharged from the hospital after restoration of normal oral feeding. CONCLUSIONS: Pancreaticogastrostomy is a safe method for reconstruction of the pancreatic remnant after pancreatoduodenectomy for periampullary tumors. It results in an acceptable incidence of anastomotic leakage that is easily controlled by conservative measures.

Adult↗
PubMed1997

Computer assisted spine surgery.

When inserting screws into a vertebral pedicle, the surgeon usually exposes the back part of the vertebra and uses his or her anatomic knowledge to align the drill in the proper direction. A slight error in direction may result in an important error in the position of the tip of the screw. This is done with no direct visibility of crucial structures (spinal cord, pleura, vessels). Statistical analysis of a series of surgical procedures has shown that 10% to 40% of the screws are not installed correctly. To reduce the risk of complication, a computer assisted method is proposed that enables the surgeon to place a screw at a position preoperatively defined in 3 dimensions using computed tomography images. This allows the surgeon to align a standard surgical drill with the optimal position and direction. The depth of the pilot hole during drilling also is monitored by the system to prevent penetration of the anterior cortex of the vertebral body. Using this procedure, in vitro tests were performed and showed that an accuracy of less than 1 mm can be obtained. Clinical trials were done in 10 patients who suffered severe scoliosis or spondylolisthesis. The trajectory of the holes drilled in L2, L3, L4, and L5 vertebrae were checked for all clinical tests. Postoperative radiographs and computed tomography scans showed that the screws were well inserted in each plane for each pedicle. This technique also can be used to perform osteosynthesis at the thoracic and cervical levels.

Adult↗
PubMed1997

Inclusion of pethidine in lidocaine for infiltration improves analgesia following tonsillectomy in children.

BACKGROUND: Previous work has demonstrated that pethidine exerts local anaesthetic effects on peripheral nerves in vivo. We examined the effects of infiltration anaesthesia by a combination of pethidine and lidocaine on post-tonsillectomy pain and restlessness in children. METHODS: Eighty children were randomly allocated to receive peritonsillar infiltration postoperatively with 3 ml of lidocaine 2% (1.5 ml on each side) combined with either 0.1 ml pethidine, 10 mg.ml-1, (pethidine group) or 0.1 ml normal saline (control group). Pain and behaviour were assessed at 1, 3, 6 and 12 h postoperatively and on the following morning by the patients and by a nurse blinded to previous treatment. RESULTS: Patients in the pethidine group had lower pain scores than those in the control group at rest as well as swallowing during the whole observation period (P < 0.05). Paracetamol was given to 34/40 children in the control group and to 6/40 children in the pethidine group. The corresponding figures for pethidine administration were 6/40 and 0/40, respectively. Patients in the pethidine group displayed a more rapid return to calm wakefulness than those in the control group (P < 0.01). CONCLUSION: Inclusion of a low dose of pethidine in lidocaine for tonsillar infiltration improves pain relief after tonsillectomy in children.

Analgesics, Opioid↗
PubMed1997

Unusual spontaneous hepatic vein to paraumbilical vein shunt in a patient with Budd-Chiari syndrome and cirrhosis: a case report.

A very unusual portosystemic shunt was identified using color flow Doppler sonography in an adult male with Budd-Chiari syndrome and cirrhosis secondary to a hypercoagulability state. Hepatofugal blood flow was demonstrated between the middle hepatic vein and a recanalized paraumbilical vein, resulting clinically in prominent periumbilical veins. The clinical and radiological features are described.

Adult↗
PubMed1997

Bladder outlet obstruction by a lymphocele following kidney transplantation.

Lymphocele is a well-known complication of kidney transplantation. Patients usually present with deteriorating renal function, hydronephrosis, a nontender lower abdominal mass or ipsilateral leg edema. Urinary retention, however, is an unusual presentation of lymphocele. We herein report a case of a female patient who developed chronic urinary retention due to a pelvic lymphocele after kidney transplantation.

Chronic Disease↗
PubMed1997

National surveillance of poultry diseases in Lebanon.

From 1992 to mid-1996, a national survey of poultry diseases in Lebanon was conducted. This surveillance included meat breeder, layer breeder, commercial layer and chicken broiler flocks. The history, signs, lesions and laboratory tests of poultry were used in the diagnosis of prevalent poultry diseases. Culture techniques were used to screen for bacterial diseases; serological techniques and, to a lesser extent, culture techniques were used to diagnose viral diseases; and both serological and culture techniques were used to diagnose Mycoplasma infections. The outbreaks of diseases detected in broiler breeder flocks and the number of such flocks experiencing these diseases were as follows: femoral head necrosis (6), egg-drop syndrome (3), reovirus-associated malabsorption syndrome (3), synovitis (Mycoplasma synoviae infection) (7), swollen head syndrome (SHS) (3), tenosynovitis (viral arthritis) (1), lymphoid leukosis (3), avian encephalomyelitis (1), fowl pox (1) and aortic rupture (1). The disease outbreaks detected in layer breeders were as follows: SHS (2), bumble foot (2), egg-drop syndrome (3) and avian infectious bronchitis (IB) (1). The disease outbreaks detected in commercial layer flocks were as follows: egg-drop syndrome (5), avian infectious laryngotracheitis (2), avian IB (nephrogenic strain) (1), malabsorption (1), avian tuberculosis (Mycobacterium avium) (1), Marek's disease (1), fowl pox (1), Salmonella enterica subsp. enterica Enteritidis infection (1), salpingitis (1) and Heterakis gallinae infestation (1). The disease outbreaks detected in broiler flocks were as follows: colibacillosis (40), infectious bursal disease (Gumboro disease) (15), malabsorption syndrome (8), avian infectious laryngotracheitis (8), paratyphoids (salmonellosis) (7), femoral head necrosis (8), SHS (6), avian mycoplasmosis (Mycoplasma gallisepticum infection) (6), synovitis (7), avian IB (6), botulism (1), avian encephalomyelitis (1) and gangrenous dermatitis (1). Diseases which occurred and which were reported for the first time in Lebanon were as follows: bumble foot, femoral head necrosis, avian IB (nephrogenic strain), malabsorption syndrome and SHS. This surveillance helped to establish baseline data concerning the predominant poultry diseases in Lebanon. Such information is a prerequisite for future regional and international collaboration to identify the source of the aetiological agents and to control their spread to neighbouring countries.

Adenoviridae Infections↗
PubMed1996

Salmonella infection and pneumonia in a patient with kyphoscoliosis.

Pulmonary involvement is an uncommon extraintestinal manifestation of salmonellosis. We describe a 30 year old man with mental retardation, presenting with salmonella gastroenteritis and bacteremia. An early pneumonia evolving in the clinical setting of severe kyphoscoliosis, suggests that hematogenous spread to the lungs may occur as a result of abnormalities of the chest wall.

Adult↗
PubMed1996

Gallbladder varices: a case report and review of the literature.

We present an 18 year old woman suffering from cavernous transformation of the portal vein, hypersplenism and bleeding esophageal varices. Color flow Doppler sonography showed gallbladder wall varices. A review of the literature, revealed 76 cases of gallbladder varices. Mostly, these were associated with portal vein occlusion and rarely with hemobilia. The color flow Doppler was the gold standard procedure for the diagnosis, although angiography, computerized tomography and magnetic resonance had also been reported. Surgeons should be aware of this finding since these varices can be a source of major blood loss.

Adolescent↗
PubMed1996

Successful renal transplantation from two donors with methanol intoxication.

Two patients with acute methanol intoxication are reported, one with acute renal failure. Both were declared brain-dead and kidneys were harvested at 80 and 130 hr after hospital admission. All four kidneys were transplanted and subsequently functioned well. In both donors who had received ethanol treatment, thrombocytopenia was present. The reluctance to use kidneys from such donors and from donors with acute renal failure before harvesting is discussed. Waiting lists for renal transplantation are growing and there is a world-wide shortage of cadaver organs. We were recently surprised to find reluctance to consider two local patients dying from methanol intoxication as suitable organ donors, and we report the outcome of four kidneys transplanted from these donors. We were unable to find any similar cases reported in the English literature.

Adult↗
PubMed1996

Acute perigraft seroma simulating anastomotic bleeding of a PTFE graft applied as an arteriovenous shunt for hemodialysis.

Perigraft seroma is an uncommonly reported complication of polytetrafluoroethylene grafts applied as an arteriovenous shunt for hemodialysis. It usually presents as a soft tissue swelling around the arterial end of the graft and occurs within 30 days after implantation. An unusual presentation of perigraft seroma occurring immediately after implantation is reported herein.

Adult↗