Biomedical subjects
Publications and source records attributed to H Amirikia.
A mucin-producing adenocarcinoma arose in a well-differentiated, mature, cystic teratoma. The patient underwent a total abdominal hysterectomy, left salpingo-oophorectomy, omentectomy and paraaortic lymph node biopsy. The prognosis is unfavorable when the tumor extends through the cyst wall and involves intraperitoneal structures.
Ten patients with female gender dysphoria were treated with exogenous androgen (testosterone [T] enanthate USP) and underwent sex reassignment surgery. Histologic changes of the ovaries of this treated group were studied and compared with those of patients with polycystic ovarian syndrome (PCO) and a normal control group. Significant differences among groups were observed for thickness of the tunica albuginea (639.8 +/- 56.5 micron, 529.2 +/- 59.3 micron, and 170.1 +/- 29.8 micron in the exogenous androgens, PCO, and normal groups, respectively), basal membrane thickness (72.8 +/- 2.8 micron, 46.2 +/- 4.2 micron, and 25.2 micron), number of cystic follicles (2.0 +/- 0.4, 5.8 +/- 0.7, and 1.8 +/- 0.8), and T and luteinizing hormone concentrations. Theca cell hyperplasia was present only in the PCO group. It is concluded that exogenous androgen can thicken the tunica albuginea and basal membrane and that these histologic changes are similar to those seen in PCO ovaries under excess endogenous androgen production.
During 15 years (1965 through 1979), 9,718 cesarean sections were performed at Hutzel Hospital. This report concerns the indications, incidence, morbidity, and mortality. Dystocia, fetal distress, and breech presentations were the most common indications for primary cesarean section. The incidence rose from 9.8% to 16.8% during this study. Forceps deliveries dropped from 47.5% to 12.0% and vaginal breech deliveries decreased from 86% to 35%. Spinal anesthesia was used in 90%. Caesarean section hysterectomies were performed in 128. The most common indications were carcinoma in situ of the cervix, uterine leiomyoma, and hemorrhage. Puerperal sepsis and urinary tract and wound infections were the major causes of morbidity. Perinatal mortality decreased from 40% to 29%. There were 10 maternal deaths. Sepsis was the major cause of death. At least four deaths could have been avoided if ultra-high-risk patients had not been pregnant in the first place.
This report concerns the indications, morbidity, and death associated with 6,435 consecutive abdominal and vaginal hysterectomies at Hutzel Hospital during a 10 year period. There was an extraordinary number of high-risk patients included in this group. Morbidity and postoperative bleeding were more common following vaginal rather than abdominal hysterectomy. These complications were also more common when the operation was performed during the proliferative phase of the menstrual cycle. There were 17 deaths. Thromboembolic complications were the major cause of death. Selective use of prophylactic antibiotics and low-dose heparin and reduction in the number of blood transfusions by preoperative endocrine and hematinic therapy may reduce the postoperative morbidity and mortality rates. Probably few operations will ever contribute as much to improving the quality of life of women as do indicated hysterectomies. However, the added risk do not seem to justify utilizing this operation for the sole purpose of sterilization in preference to simpler and safer procedures.
A report of a patient with granulomatous peritonitis following general surgery is presented. Laparoscopy was performed as the final diagnostic procedure. Prevention is the remedy for this iatrogenic problem.
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