Biomedical subjects

M E Moussa

Publications and source records attributed to M E Moussa.

5 recordsLinked to original sources

PubMed1996

Effect of total hepatic vascular exclusion during liver resection on hepatic ultrastructure.

The aim of this investigation was to observe ultrastructural changes in the liver in response to warm ischemia during liver surgery. In 11 noncirrhotic patients, hepatic resection was performed under total vascular exclusion (TVE). The mean duration of warm ischemia was 28 minutes (range 16-48 minutes). Three specimens were taken from each patient: before clamping, at the end of TVE, and after reperfusion. Biopsy specimens were studied by light microscopy and by transmission electron microscopy (EM). At the end of the ischemic phase sinusoids were collapsed with resultant loss of normal hepatic architecture. Morphological changes to hepatocytes included focal chromatin condensation at the nuclear margins, distended nuclear envelope, and swelling of both mitochondria and endoplasmic reticulum. After reperfusion these changes reversed. The phenomenon of sinusoidal and hepatocellular recovery after TVE was seen in all the cases of this study, irrespective of age, sex, disease, type and severity of surgical intervention, and duration of TVE. It can be concluded that TVE over a period of 48 minutes has no irreversible deleterious effects on the ultrastructure of the noncirrhotic liver.

Adult↗

PubMed1996

Why is colonoscopy more difficult in women?

BACKGROUND: In our experience colonoscopy in women is more difficult than in men. A retrospective review of 2194 colonoscopies performed by a single experienced endoscopist (CBW) showed that 31% of examinations in women were considered technically difficult compared with 16% in men. METHODS: To investigate a possible anatomic basis for this finding, normal barium enema series from 183 female and 162 male patients were identified. From these barium enemas, measurements of colonic length and mobility were independently taken by two physicians who were unaware of each patient's gender. RESULTS: Total colonic length was greater in women (median, 155 cm) compared to men (median, 145 cm), p = 0.005, despite women's smaller stature (p < 0.0001). Although there were no significant differences in rectum plus sigmoid, descending, or ascending plus cecum segmental lengths, women had longer transverse colons (female median length, 48 cm; male median length, 40 cm), p < 0.0001. There were no differences in mobility of the descending colon and transverse colon between the sexes, but the transverse colon reached the true pelvis more often in women (62%) than in men (26%), p < 0.001. CONCLUSIONS: Colonoscopy appears to be a technically more difficult procedure in women. The reason for this may be due in part to an inherently longer colon.

Adolescent↗

PubMed1995

Can barium enema indicate when colonoscopy will be difficult?

The barium enemas of 48 consecutive patients, who were technically difficult to intubate at colonoscopy, were compared to those of 46 patients who were not. Measurements were taken of colonic length and mobility, and an assessment made of diverticular disease. Rectosigmoid length (mean difficult group = 61 cm, mean control = 54 cm, P = 0.01) and total colonic length (mean difficult group = 157 cm, mean control = 140 cm, P < 0.0001) were greater in the difficult colonoscopy group as were transverse colon mobility (mean difficult group = 10 cm, mean control = 7 cm, P = 0.003) or redundancy (transverse colon reaching the true pelvis on the erect film); 65% difficult group vs 17% control group, P < 0.0001. The presence of moderate or severe diverticular disease was also greater in the difficult (23%) compared to the control (4%) group, P = 0.02. When available, assessment of a previous barium enema is a useful guide to probable technical difficulty of colonscopy. It may allow appropriate allocation of potentially difficult cases to specialist endoscopy lists.

Adolescent↗

PubMed1995

Repeated resection for malignant liver tumours.

Fifteen repeat hepatic resections were performed on 12 patients with either recurrent or residual malignant tumours of the liver. Of these, one patient underwent three repeat resections and another underwent two. Five had primary liver liver tumours and seven had liver metastases. Planned, 'staged', repeat resections were performed on three patients because of multiple deposits of tumour, cirrhosis or extensive disease at initial presentation. There was no operative mortality. The period of follow-up from the time of repeat sections ranged between 4 months and 36 months during which two patients died from recurrent disease. The mean survival after the repeat resection was 16.8 months (range 4-36 months). Although technically demanding, repeat hepatectomy is feasible and provide similar benefits.

Aged↗

PubMed1994

The evaluation of an Arabic version of Rose questionnaire.

An Arabic version of Rose questionnaire was tested to establish its credibility as an epidemiological tool for screening purposes. The study showed that the criteria used in defining CHD determinants were still applicable today and in Arabic. The Arabic version maintained similar, if not better, sensitivity and specificity results than its original counterpart. The study pointed out, however, to several limitations that should be kept in mind during the interpretation of the questionnaire results.

Adult↗