Small bowel flora and bacterial translocation in potential small bowel transplant donors.
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Adolescent↗
Biomedical subjects
H Hajj
Publications and source records attributed to H Hajj.
Orthotopic liver transplantation for hepatic-based metabolic disorders.
Between January 1989 and June 1993, a total of 470 liver transplantations were performed at King's College Hospital. Thirty-seven transplantations were performed in 34 patients with liver-based metabolic disease. There were 16 females and 18 males with a median age of 19 years (range 1 month to 62 years). There were 14 patients under 16 years of age. The indications for liver transplantation were Wilson's disease (n = 16), alpha 1-antitrypsin deficiency (n = 10), tyrosinaemia (n = 2), primary hyperoxaluria type 1 (PH1; n = 2), congenital haemochromatosis (n = 1), familial amyloidotic polyneuropathy (FAP; n = 1, familial hypercholesterolaemia) (n = 1) and Crigler-Najjar syndrome type I (CNS1; n = 1). These included two patients who received combined heart-liver grafts for familial hypercholesterolaemia and FAP, respectively. Two patients received combined liver-kidney transplants for PH1. There were four deaths: from sepsis (n = 2), acute hepatic vein obstruction in a left lateral segment graft (n = 1) and portal vein thrombosis with liver necrosis (n = 1). Three patients were retransplanted, one for chronic rejection and two for hepatic artery thrombosis, giving an overall graft survival of 81% and patient survival of 88% (30/34), at a mean follow-up of 34 months (range 10-64 months).
Acute Disease↗
Penetrating missile embolisation.
The present case report is that of a 13-year-old boy, who was admitted to the Emergency Unit at the American University of Beirut Medical Center (AUBMC), with a bullet injury to the right upper quadrant with no exist. Chest X-ray and KUB failed to reveal the bullet and there was no evidence of haemo- or pneumothorax. X-ray of both thighs showed the bullet at the level of the right groin. The bullet penetrated the liver, diaphragm and pericardium. It entered through the left ventricle and embolised through the arterial circulation to the right superficial femoral artery. Included in this report is a review and analysis of patients with missile embolisation, who were treated at the AUBMC over the last 10 years.
Abdominal Injuries↗
Popliteal vein entrapment in the normal population.
The aim of this study was to determine the incidence and severity of popliteal vein compression by full knee extension in the normal population. The popliteal veins in 100 healthy volunteers (200 limbs) with no history of previous deep vein thrombosis (DVT) or venous obstruction were examined using duplex scanning with the knee slightly flexed and then fully extended. Knee extension produced complete obstruction in 17 subjects and severe obstruction (< 50% decrease in diameter) in a further 10 subjects. Thirteen subjects had unilateral compression and 14 bilateral. The 27 subjects were tested for functional venous outflow obstruction with air plethysmography. In flexion, the outflow fraction was normal (> 40%) in all subjects. With the knee fully extended, severe or complete venous obstruction (outflow fraction < 10%) was found in eight subjects. Moderate obstruction (outflow fraction 10-40%) was found in all the remaining 19 subjects. When digital compression of the long saphenous vein was performed, these subjects also demonstrated severe outflow obstruction. Although the incidence of symptoms of functional venous obstruction is rare in the general population, these findings have important implications for venous stasis for patients on the operating table and in those having prolonged bed rest. Studies investigating the association between popliteal vein compression and postoperative deep venous thrombosis are needed.
Adult↗
Trauma management in a war zone: the Lebanese war experience.
Lessons learned from the Vietnam and Korean conflicts have emphasized the necessity of an organized preparedness for optimal management of casualties. The present report summarizes the experience of a tertiary care center in the present Lebanese war. Between 1975 and 1986, approximately 30,000 war casualties were treated at the American University of Beirut Medical Center (AUBMC). A disaster plan was implemented whenever more than 25 major trauma victims were received within 1 hour. In-field stabilization and emergency room (ER) thoracotomy were not employed. The results are illustrated by an analysis of 1,500 cases of abdominal trauma, (1,314 high-velocity gunshot wounds, 29 stab wounds, 157 blunt injuries). A total of 1,420 patients were operated on within 6 hours of admission and 711 within the first hour. Overall mortality was 130, 8.7%; 9.5% for gunshot wounds, 3.4% for stab wounds, and 2.5% for blunt trauma. One hundred forty-five patients or 9.7% had negative findings at laparotomy. The factors affecting mortality were hypotension on admission (26.5% for a BP less than 90 mm Hg and 2.8% for a BP higher than 90 mm Hg) and the presence of extra-abdominal injuries (14.4% with and 4.4% without). The chief causes of death were hemorrhage (3.7%), sepsis (2.1%), and ARDS (1.2%).
Abdominal Injuries↗
Penetrating trauma to the carotid vessels.
Over a 13 year period extending between April 1975 and June 1988, 510 neck injuries were treated at the American University of Beirut Medical Center; the carotid vessels were involved in 48 patients, resulting in 53 carotid injuries. The mean age of the patients was 25.3 years and shrapnel injuries were the commonest (45.8%), followed by bullet wounds (33%). Thirty-nine patients had a laceration and five had complete disruption of the carotid vessels and only three presented in coma. Shock was present in 14 patients, of whom five had a neurological deficit. In six the injured vessels were ligated, three of them were external carotid arteries. Nine patients were not initially operated on. Six of them had a chronic arterio-venous fistula and three were in coma. The remainder underwent surgical repair. Nine patients died, giving an overall mortality rate of 18.8%. Four of these died because of multisystem failure, thus giving a 10.4% mortality rate for the isolated carotid injury. There was definite improvement in the repaired group, but the haemodynamic status seemed to significantly affect the mortality rate (P less than 0.01). Follow-up of surviving patients has revealed five with persistent neurological deficits in the repaired group (33 patients), and four patients with a chronic arterio-venous fistula. Two patients had a false aneurysm. Carotid artery injury seems to have a good prognosis if repaired promptly within 3 h.
Adult↗
Purification of an estrogen-regulated breast cancer protein by monoclonal antibody affinity chromatography.
An estrogen-regulated cytoplasmic protein has been purified from MCF-7 human breast cancer cells with anion exchange and monoclonal antibody affinity chromatographies. The purified protein has a monomeric mol wt of 28,000 and isoelectric species with pI's between 5.9 and 6.0. Amino acid analysis indicates the protein is acidic, is probably hydrophilic, and contains unusually low amounts of methionine and half cystine. This rapid, two-step procedure produces purified protein in high yield and demonstrates the power of monoclonal antibodies in protein purification.
Amino Acids↗
Detection of a Mr 24,000 estrogen-regulated protein in human breast cancer by monoclonal antibodies.
Monoclonal antibodies have been prepared that can specifically detect an estrogen-regulated protein with a molecular weight of 24,000 in the MCF-7 human breast tumor cell line and in human breast tumor biopsies. These antibodies are of the immunoglobulin G1 subclass, exhibit a high affinity for the Mr 24,000 protein, and recognize an antigenic site that is stable to sodium dodecyl sulfate gel electrophoresis and electrophoretic transfer techniques. These monoclonal antibodies have been used to confirm estrogen regulation of the Mr 24,000 protein in MCF-7 cells and to detect Mr 24,000 protein in certain human breast tumors.
Animals↗
Testicular in vitro conversion of progesterone to testosterone and androstenedione in 17 alpha-hydroxylase deficiency.
Incubations of [3H]-progesterone with testicular tissue obtained from a new case of male with 17 alpha-hydroxylase deficiency were performed. The per cent conversion to androstenedione and testosterone was virtually absent when compared to that obtained from an identical incubation performed using testicular tissue from a normal male with cryptochordism. The findings provide an in vitro evidence in support of the existence of 17 alpha-hydroxylase testicular defect in this disorder.
Adolescent↗
Determination of growth of Sphaerotilus discophorus in the presence of manganese.
Manganese interferes strongly with most chemical methods of biomass determination. However, the biomass of manganese-encrusted Sphaerotilus discophorus can be determined after removal of the MnO2 with trichloroacetic acid and oxalic acid. Evidence which indicates that manganese inhibits the heterotrophic growth of S. discophorus and that the cells only oxidize manganese late in the growth curve is presented.
Bacterial Proteins↗