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Biomedical subjects

A Wahba

Publications and source records attributed to A Wahba.

15 recordsLinked to original sources
PubMed1992

Angioscope-guided neodymium yttrium-aluminium-garnet laser valvulotomy for in situ vein bypass.

Valvulotomy for in situ vein bypass is commonly performed with a valvulotome. Although the procedure can be controlled through an angioscope, the dangers of intimal damage and valve remnants remain. An experimental study was designed to evaluate angioscopic laser valvulotomy compared with standard mechanical valvulotomy (n = 16). Two different laser probes, a bare 400-microns fibre (n = 20) and a 2-mm hot-tip (n = 26) were tested. Results were investigated by histology and scanning electron microscopy. Hot-tip laser valvulotomy achieved significantly better results than the 400-microns fibre. The Insitucat valvulotome yielded the worst results, with valve remnants in all cases and an 88 per cent rate of intimal damage. It is concluded that laser valvulotomy can be performed simply and safely with a very low incidence of valve remnants and intimal damage.

Adult↗
PubMed1991

Coagulation in aortofemoral bifurcation bypass grafting.

Few data are available on the pathophysiology of the coagulation system during aortic surgery. Cross-clamping of the aorta, intestinal eventeration and circulatory shock in ruptured aortic aneurysms are thought to cause coagulation disturbances and hyperfibrinolysis. A prospective study of several parameters of the clotting system, i.e. standard clotting tests, platelet count, indicators of fibrinolysis, inhibitors of the clotting cascade and proteases were measured perioperatively in aortobifemoral bypass grafts. Ten patients undergoing elective procedures and two emergency cases with ruptured aortic aneurysms were included. The standard clotting tests reflected the use of heparin. A similar course of ATIII, C1-inhibitor, alpha 2-antiplasmin, plasminogen and fibrinogen with a decrease during the operation and a return to almost normal values postoperatively, were due to intra-operative blood loss, haemodilution and a slight activation of the clotting cascade, as well as, hyperfibrinolysis. This observation was supported by the increased levels of euglobulin lysis and PMN-elastase and the resultant increase in some fibrinogen degradation products, indicating non-specific proteolysis. These changes were more pronounced in the two emergency cases, except for the heparin induced changes in PTT and thrombin time. It is concluded that non-specific proteolysis may be an important factor in the pathogenesis of clotting disorders in surgery of the aorta. Further research is needed to discover the pathways of non-specific proteolysis and its prevention by protease inhibitors.

Aorta, Abdominal↗
PubMed1991

[Diagnosis and treatment of visceral and renal embolisms].

UNLABELLED: In surgical practice, about 15% of all emboli are visceral emboli. Diagnosis is frequently delayed or established at autopsy. ETIOLOGY: The most common cause are atrial arrhythmias with intraatrial thrombus formation, less frequently, ventricular thrombus after myocardial infarction or in an aneurysm, emboli from vegetations due to infective endocarditis, from atrial myxomas and, occasionally, from arteriosclerotic plaques, aortic tumors or mural aortic thrombi. Cholesterol embolism: Cholesterol embolism or the multiple cholesterol emboli syndrome (MCES) is of particular importance. There are three large groups of symptoms: a peripheral manifestation with livedo reticularis, renal manifestation with progressive renal failure and visceral manifestation with intestinal bleeding and segmental infarction. The only possibility for treatment is surgical removal of the source of embolization through infrarenal aortic replacement or suprarenal aortic arteriectomy. Renal embolism: Acute traumatic interruption of the renal perfusion in otherwise healthy subjects usually leads to loss of the organ due to the limited ischemia tolerance. On the other hand, the results of renal artery embolectomy can be favorable even after 24 hours of ischemia since, as a rule, embolism does not completely occlude the vascular lumen and, in patients with arteriosclerosis, collateral vessels are usually present. The clinical presentation usually encompasses acute onset of flank or back pain, tenderness to percussion of the kidneys, nausea, vomiting and hematuria. In 25% of the cases, the course of renal embolism is bland. The low specificity of the complaints requires delineation of high-risk patients. At the first level of diagnostics, other causes of the complaints should be ruled out with catheterization of the bladder, ultrasound, intravenous pyelography and computer tomography with intravenous contrast medium.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Crural bypass as reoperation].

A retrospective study of 93 patients who have had repeat surgery at the tibial level for critical limb ischemia was carried out. In 21 patients a pseudoocclusion with a patent bypass graft was diagnosed and treated by PTA, thrombendarterectomy, or distal extension of the graft. The 5-year bypass patency was 60%, compared to 38% in those 72 patients that required a new bypass at the tibial level. Vein bypasses were better than prosthetic grafts. The number of previous operations did not negatively influence the outcome. However, the distal anastomosis should be placed on an artery that was not previously thrombectomized or operated on.

Adult↗
PubMed1979

Monocyte function in psoriasis.

Monocytes derived from the peripheral blood of psoriatic patients demonstrated a significantly higher phagocytic capacity (36 to 40%) for both 125I-labeled Shigella flexneri and 125I-labeled Staphylococcus albus compared with monocytes from healthy subjects. Monocytes from psoriatic patients showed a 2-to-4fold increase in bactericidal capacity against S. albus when compared with normal monocytes. However, the bactericidal capacity of monocytes from diphylline-treated patients did not differ from that of the control subjects. The antibody-dependent cellular cytotoxicity (ADCC) activity against EL4 tumor cells was found to be similar in both psoriatic patients and control subjects. It is postulated that these abnormalities of monocyte function in psoriasis are caused by a decreased cAMP/cGMP ratio similar to the decreased cAMP/cGMP ratio found in the lesional epidermis of this disease. It seems therefore, that the psoriatic abnormality is not confined to only one type of cell, the epidermal cell.

Adult↗
PubMed1979

Chrome sensitivity in Israel.

Fifty-two Israeli Jewish patients suffering from chrome sensitivity (C.S.) were investigated with regard to their ethnic origin, age of onset of the dermatitis, occupational history and socio-economic level. Forty-eight patients suffering from various skin conditions and drawn from the outpatient dermatological clinic were used as controls. The socio-economic status of C.S. patients was found to be very low, regardless of ethnic origin. Ninety-four percent of the patients were non-Ashkenazi Jews and a significantly increased proportion of those (24%) were of Kurdish descent. There were no major differences in their occupations. Patients of Kurdish origin manifested the disease at a significantly earlier age than other non-Ashkenazi patients, although the socio-economic conditions of the different ethnic groups of patients were similar.

Adolescent↗
PubMed1979

Herpes simplex virus isolation from pyoderma gangrenosum lesions in a patient with chronic lymphatic leukemia.

Herpes simplex virus type 2 was isolated and identified from the vesicular border of pyoderma gangrenosum lesions on the genital region of a patient with chronic lymphatic leukemia. Dramatic relief of pain as well as quick disappearance of the vesicular margin of the lesions and of the inflammatory halo around them occurred as a result of local treatment with a solution of zinc acetate. A careful search for a viral agent should be done in every case of pyoderma gangrenosum occurring in a patient with a hematological malignancy or/and impaired immunity, especially if the lesions are on the face or in the genital region.

Acetates↗
PubMed1979

Neutrophil chemotaxis in psoriasis.

Neutrophil chemotaxis was assessed in 69 psoriatic patients and 37 healthy human subjects. It was found to be significantly enhanced in 52 untreated patients. In 20 patients treated with an orally-administered phosphodiesterase inhibitor, Diphylline, neutrophil chemotaxis was normal. The enhanced chemotactic response of neutrophils from untreated patients with minimal skin lesions was at least equal to the response of those from patients with extensive skin lesions. Preincubation of normal human leukocytes with plasma derived from patients with widespread lesions markedly reduced their chemotactic activity. Plasma derived from patients with extensive skin lesions exhibited marked chemoattracting properties in comparison with plasma from healthy subjects. It is postulated that the basic intrinsic abnormality of neutrophil function in psoriasis could be caused by a decreased cyclic AMP/cyclic GMP ratio, similar to the decreased cyclic AMP/cyclic GMP ratio found in the lesional epidermis of this disease. Plasma factors which influence chemotaxis in psoriasis are related to the extent of the eruption and their effect is contrary to the effect of the basic intrinsic abnormality of psoriatic neutrophils.

Administration, Oral↗
PubMed1978

Enhanced chemotactic and phagocytic activities of leukocytes in psoriasis vulgaris.

Leukocytes derived from the peripheral blood of psoriatic patients demonstrated an enhanced chemotactic response compared with leukocytes from healthy subjects. No significant difference was detected between the chemotactic response of leukocytes from patients with minimal or no skin involvement and those from patients with extensive lesions. Psoriatic leukocytes also had a significantly higher capacity to engulf 125I labeled Shigella flexneri than control leukocytes. It is postulated that a decrease in the cyclic AMP/cyclic GMP ratio in psoriatic leukocytes, similar to the imbalance of these 2 cyclic nucleotides found in the lesional epidermis of psoriasis, might be the cause of their enhanced chemotactic and phagocytic activities.

Cyclic AMP↗
PubMed1978

Leukocyte motility in acne conglobata.

Leukocytes derived from the peripheral blood of 10 patients with acne conglobata demonstrated enhanced chemotactic and random migratory activities in comparison with leukocytes from 10 healthy subjects. This enhancement is most probably secondary to the state of chronic infection and inflammation. These findings probably rule out a defect in leukocyte motility as a cause of the severity of the lesions in acne conglobata.

Acne Vulgaris↗