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Biomedical subjects

F D Salama

Publications and source records attributed to F D Salama.

At least 37 records · Page 2Linked to original sources
PubMed1990

Long-term results of the Belsey Mark IV antireflux operation in relation to the severity of esophagitis.

A retrospective analysis of the results of the Belsey Mark IV operation has been conducted, relating these to the degree of esophagitis present preoperatively. Analysis of 89 patients showed a 91.7% success rate in patients without esophagitis. Good results diminished steadily as the severity of esophagitis increased, giving 76.5%, 75%, 66.7%, and 50% success rates for first-, second-, third-, and fourth-degree esophagitis, respectively. We believe that shortening of the esophagus is an important factor in this. Shortening is obvious in third- and fourth-degree esophagitis but subtle in first- and second-degree esophagitis. We conclude that the Belsey operation is adequate for patients without esophagitis, but for patients with any degree of esophagitis more effective reflux control is needed.

Adult↗
PubMed1989

The role of computed tomography in assessing the operability of oesophageal carcinoma.

The reliability of CT scanning in assessing resectability in carcinoma of the oesophagus was investigated prospectively by direct comparison with the operative findings. Over 11 months, 38 patients judged potentially operable following conventional investigation underwent CT scanning from the thoracic inlet to the level of the adrenal glands. These patients were then explored surgically with a view to resection. The CT findings were assessed by two radiologists without access to clinical information. Operative findings were recorded by the surgeon. Comparison was made between the tomographic and surgical findings specifically assessing: longitudinal tumour extent, direct mediastinal infiltration, invasion of other mediastinal structures, lymph node involvement and the presence of hepatic and pulmonary metastases. The sensitivity and specificity of the scan for each feature was then calculated. Scan sensitivity was poor, ranging from 0%-66.7%. Specificity was better with a range of 70.8%-100% according to the criterion studied. We conclude that the poor sensitivity means that CT scanning is of little value in the preoperative assessment of resectability in oesophageal carcinoma.

Aged↗
PubMed1989

Resection for carcinoma of the oesophagus.

One hundred and seventy-one patients with oesophageal carcinoma were seen in the 7-year period October 1976 to September 1983. One hundred and thirty-three cases (77.8%) were explored with a view to curative resection. This was accomplished in 98 cases (73.6% of explored patients, 57.3% of the entire group). Overall operative mortality was 10.2%. Of patients undergoing curative resection, 9% developed benign strictures which responded to 1-4 dilatations, while 14.8% developed local recurrence which marked the terminal event. After excluding operative deaths, 61.3% of patients survived for 1 year, 27% for 3 years and 17.3% for 5 years. Five-year survival for patients with squamous carcinoma was 36% while that for adenocarcinoma patients was only 3%. It is concluded that curative resection can be accomplished in a selected group of patients dealt with in a specialized unit with low operative mortality. This approach offers the patient good palliation and the best chance of prolonged survival.

Carcinoma↗
PubMed1986

Primary oat cell carcinoma of the oesophagus.

Three cases of oat cell carcinoma of the oesophagus are presented and published reports reviewed. This is mainly a disease of older age with a 3:2 predominance of men. Of all published cases, 43 (47.3%) occurred in the middle third, 41 (45.1%) in the lower third, and four (4.4%) in the upper third. In one case it was multifocal and in two the location was not stated. Dysphagia was the most common symptom and was found in 82.5% of cases. Overall survival was 4.7 months. The longest survival in a patient treated by resection was 24 months and in a patient treated by chemotherapy 11 months. All but one of the patients had widely disseminated metastatic disease at death. It is concluded that surgery, possibly with adjuvant chemotherapy, holds out the best prospect for such patients.

Aged↗
PubMed1985

Primary chest wall tumors.

A retrospective study of 53 primary chest wall tumors, 26 benign and 27 malignant, was carried out to review their clinical radiological and pathological features. Forty-nine of the 53 lesions presented in the ribs and the remaining 4, in the sternum. The overall 5-year survival for patients with primary malignant neoplasms of the chest wall was 33.3%, and the 10-year survival was 18.5%. All of the deaths were disease related. All of the patients with benign tumors were treated by excision without recurrence or death. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissues were visualized. On the basis of our analysis, we believe that all tumors of the chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain an adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions.

Adolescent↗
PubMed1985

Oesophageal intramural pseudodiverticulosis.

Twelve cases of oesophageal intramural pseudodiverticulosis are described and the findings in 85 previously reported cases are reviewed. The condition occurs in all age groups, predominantly in the sixth and seventh decades, with a slight predilection for males. The characteristic radiographic appearance is of multiple flask shaped outpouchings of 1-4 mm with narrow necks communicating with the oesophageal lumen. The source of the pseudodiverticula has been shown to be pathologically dilated excretory ducts of the submucous glands due to chronic submucosal inflammation. The distribution was segmental in 57 cases (59%) and diffuse in 40 (41%). Dysphagia is the main symptom and was found in 85 cases (88%); 88 cases out of 97 had radiological narrowing of the oesophagus; of these, 39 (44%) were in the upper oesophagus, 20 (23%) in the middle oesophagus, and 29 (33%) in the lower oesophagus. Treatment is directed towards management of the associated disorder, as the diverticula themselves rarely cause problems.

Adult↗
PubMed1984

Aneurysmal bone cyst of the rib.

Aneurysmal bone cysts are uncommon lesions, especially in the ribs. Four patients with aneurysmal bone cysts of the rib are presented and previously reported cases reviewed. A brief discussion of the clinical manifestations, pathology, aetiology, and current treatment of aneurysmal bone cyst is also included.

Adolescent↗
PubMed1977

Primary fibrosarcoma of the diaphragm.

Primary tumours of the diaphragm are rare. Benign neoplasms occur more frequently than malignant ones. Among the latter, fibrosarcoma is the most common. A case of primary fibrosarcoma of the diaphragm is presented with long survival and recurrence 10 years after first surgical removal. At re-operation, a huge tumour was excised arising from a small part of the diaphragm. The histology of the recurrence was the same as the original tumour. The patient remained free of signs and symptoms nine months after the second operation.

Diaphragm↗
PubMed1976

A suggested site for the implantation of myocardial pacemakers in infants and young children.

A new site for burying an implantable pacemaker in infants and young children is described. The Medtronic sutureless screw electrode is applied to the diaphragmatic surface of the heart through a transxiphoid approach. The unit is inserted in the abdominal wall between the transversalis fascia and the transversus muscle. The method is simple, taking approximately 30 minutes to complete. It avoids thoracotomy. The unit is well concealed and protected. The coils of the lead are relatively free from adhesions and allow for growth in the child.

Abdominal Muscles↗
PubMed1975

Surgical correction of aortic valve stenosis with persistent ductus arterious and servere pulmonary hypertension.

This is a report of a case in which the unusual association of severe aortic valve stenosis with persistent ductus arteriosus complicated by severe pulmonary hypertension, was diagnosed and correction of the anatomical lesions carried out in one stage. Re-investigation after one year showed that the duct was closed, the pulmonary artery pressure was lower than before the operation and the gradient across the aortic valve reduced. A modern approach to treatment based on full cardiac assessment is stressed. Problems arising during the operation are discussed.

Angiography↗
PubMed1975

Prosthetic replacement of the esophagus.

A tubular prosthesis was initially made of silicone rubber, spot-bonded on the inside and outside to a layer of knitted Dacron. This was covered on the outside by a loose layer of knitted Dacron, attached to the rubber only at the two ends, to allow incorporation by fibrous tissue and fixation of the prosthesis. Anastomoses were made with one layer of continuous sutures. There was initial incorporation of the graft. After 29 to 44 days the tube became loose and migrated, leaving a stricture. The prosthesis was redesigned with two loose layers of wider mesh. Incorporation occurred early with abundant fibrous reaction. Separation of the tube started at 40 days and was complete within 72 to 152 days. When the sutures became disengaged, bacteria entered the space between rubber and incorporated fabric, resulting in collagen lysis and separation of the tube. There were no anastomotic leaks in the entire series.

Animals↗