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Biomedical subjects

M A el-Gendi

Publications and source records attributed to M A el-Gendi.

7 recordsLinked to original sources
PubMed1988

Histamine and histamine receptor antagonists in splanchnic compartments in schistosomal portal hypertension.

The type and distribution of histamine receptors in the portal circulation were studied in patients with schistosomal hypertension. At laparotomy, the umbilical, left gastric, splenic, and superior mesenteric veins were cannulated. Blood samples were drawn from the systemic circulation and from each vein for histamine assay. Portal pressures were then estimated in each vein. One group of patients received local injections of pheniramine p-aminosalicylate (H1-antagonist) in the four cannulated veins simultaneously. A second group received cimetidine (H2-antagonist), and a third group received a mixture of both drugs. Reestimation of portal pressures indicated that all treatments produced a significant drop in pressure in the four compartments. The highest drop was in the splenic vein after the H1-antagonist and in the gastric vein after the H2-antagonist. The histamine level was somewhat higher in the splenic compartment. These results suggest that both H1- and H2-receptors are present in the four portal compartments, but their distribution may not be uniform.

Adult↗
PubMed1987

Lymphocyte and erythrocyte turnover in thoracic duct lymph in patients with schistosomal hepatosplenomegaly and portal hypertension.

In 60 patients with hepatosplenic schistosomiasis and portal hypertension and in 20 control subjects, the turnover of erythrocytes and lymphocytes circulating in thoracic duct lymph was compared. Despite slight anemia in most patients with schistosomiasis, there was a greatly accelerated extravascular splanchnic circulation rate of erythrocytes. Lymphocytes also circulated more rapidly, but in contrast to erythrocytes, the peripheral blood lymphocyte count was elevated in schistosomal patients. Although thoracic duct lymph flow was increased at all stages of schistosomiasis, it was less rapid in "ascitic" and "varix bleeders" and thus the extravascular circulation turnover of erythrocytes and lymphocytes appeared to decline with chronicity of disease. The more rapid lymphocyte and erythrocyte "turnover," however, was almost entirely due to increased formation of interstitial fluid (greater lymph flow) suggesting that a prime regulator of splanchnic cellular migration was "solvent drag." These findings may derive from deranged portal microvascular dynamics (e.g., increased microvascular pressure, collagen deposition in Disse's space, capillarization of hepatic sinusoids, presinusoidal obstruction) as well as generalized host immunoresponsiveness to schistosomal infection.

Erythrocytes↗
PubMed1986

Anorectal pressure in patients with symptomatic hemorrhoids.

This study was carried out on 30 patients with symptomatic internal hemorrhoids and 20 normal controls. The anal sphincter pressure was studied before and after surgery. A significantly high anal pressure was found in all patients with symptomatic internal hemorrhoids, when compared with normal controls, and there was no relation between this increase and the degree of hemorrhoids. One week following surgery, this high pressure was reduced significantly and was not affected by the type of operation. Thus, this increase in resting anal pressure is due to an overactivity of the internal hemorrhoids, which is secondary to the presence of the hemorrhoidal mass.

Adult↗
PubMed1979

Radiographic and haemodynamic patterns of portal hypertension in hepatosplenic schistosomiasis: selection of surgical procedure.

Twenty-eight patients with hepatosplenic schistosomiasis and portal hypertension were studied. The transumbilical portal pressure, transsplenic portal pressure, and thoracic duct occluded pressure were measured simultaneously and thoracic duct lymph flow estimated. Changes in the splanchnic vasculature were studied radiologically barium swallow, splenoportography, and umbilical portography. The transumbilical-transsplenic portal pressure gradient was found to be of particular value. The gradient was considered to be positive when the transumbilical portal pressure was higher than the transsplenic portal pressure, in such cases the primary generating factor of portal hypertension and/or ascites was most probably of hepatic origin. The gradient was considered to be negative when the transumbilical portal pressure was lower than the transsplenic portal pressure; in such cases the primary generating factor of portal hypertension and/or ascites was most probably of splenic or prehepatic origin. A correlation was found between the type of gradient and the radiographic pattern met with. For instance, in cases with positive gradient the hepatic blood flows, as estimated from the splenoportography, were mostly stage I or II, and showed no retrograde portal vein flow on umbilical portography. While, in cases with negative gradients, the hepatic blood flows were mostly stage III or IV, and showed retrograde portal vein flow on umbilical portography. The type of gradient, the clinicopathological stage, and the radiographic changes in the splanchnic vasculature were taken into account in selecting the surgical procedure to be used in each individual case.

Hemodynamics↗
PubMedDate not supplied

Portal pressure measurements before and after Hassab's decongestion operation. A preliminary report.

This preliminary study included five patients with a history of haematemesis resulting from rupture of oesophageal varices complicating schistosomal hepatic fibrosis. Simultaneous measurements were taken of the endoscopic variceal pressure (EVP) and the free portal pressure (FPP) obtained by the cannulation of a mesenteric vein radical. These measurements were taken after laparotomy, after removing the spleen and after devascularization of the lower oesophagus and upper two thirds of the stomach. At the beginning the EVP was found to be identical with the FPP. Following splenectomy, the EVP dropped from a mean of 41.9 cm H2O to a mean of 25.8 cm H2O, whereas the FPP dropped from 40.7 cm H2O to 27.8 cm H2O. After decongestion, the EVP had a mean of 21.3 cm H2O and the FPP had a mean of 32 cm H2O. Two weeks after the operation the EVP remained unchanged at the end of the operation in two cases and increased by 5 cm H2O in one case. Accordingly it was concluded that Hassab's operation results in an immediate diminution of the EVP and FPP. However, the long-term results of this operation required further studies.

Adult↗
PubMedDate not supplied

Effect of gastro-esophageal decongestion on variceal pressure in patients with schistosomal hepatic fibrosis.

This study includes 60 patients having schistosomal hepatic fibrosis and esophageal varices. Splenectomy alone was done for 14 patients having no history of haematemesis and gastroesophageal decongestion with splenectomy was done for the remaining 46 patients with history of haematemesis. Endoscopic variceal pressure measurements were done to all of them peroperatively and 21 days postoperatively. 17 patients, 7 after splenectomy and 10 after gastro-esophageal decongestion, were followed for 18 months post operatively. 21 days postsplenectomy, the variceal pressure dropped insignificantly from 38.09 to 33.27 cm H2O. During the following 18 months, three patients out of seven showed significant increase in variceal pressure. After decongestion with splenectomy, the mean variceal pressure dropped significantly from 42.03 to 29.17 cm H2O. For the 10 patients followed for 18 months, eight of them retained their variceal pressure as low as early postoperative figures. Thus gastro-esophageal decongestion with splenectomy is effective in reducing variceal pressure and in so doing it is better than splenectomy alone.

Adolescent↗