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Biomedical subjects

M Haj

Publications and source records attributed to M Haj.

At least 19 recordsLinked to original sources
PubMed2000

Evaluation of seprafilm and amniotic membrane as adhesion prophylaxis in mesh repair of abdominal wall hernia in rats.

INTRODUCTION: Adhesion formation following abdominal wall hernia repair with prosthetic mesh may lead to intestinal obstruction and enterocutaneous fistula. Physical barriers, namely, human amniotic membrane (HAM) or Seprafilm (Genzyme, Cambridge, Mass., USA), a bio-absorbable, translucent membrane composed of carboxymethylcellulose and hyaluronic acid, have been reported to prevent postsurgical intra-abdominal adhesions. OBJECTIVE: Evaluating the effect of HAM and Seprafilm in preventing adhesion formation in the rat model of ventral hernia repair with polypropylene mesh (PPM). MATERIAL AND METHODS: Sixty female Sprague-Dawley rats were divided into three groups. A full-thickness abdominal wall defect was created in each animal. Control animals had the PPM sutured into the defect, whereas in the other two groups, either HAM or Seprafilm were laid over the abdominal viscera before the repair with PPM. Half of the animals in each group were sacrificed on the 21st postoperative day. The remaining rats of the same group were re-operated on the 42nd day for investigation and measurement of the adhesion area in relation to the graft area. RESULTS: Direct mesh repair showed 52.8 and 56% area adhesion formation 3 and 6 weeks postoperatively, respectively. The HAM barrier covered with mesh repair demonstrated 0 and 0.96% area adhesion formation, and the Seprafilm-covered mesh repair showed 0 and 0% area adhesion formation 3 and 6 weeks postoperatively, respectively. Uncovered mesh showed a significantly larger adhesion area than both covered mesh (p = 0.001 and 0.001). Both HAM and Seprafilm were equally effective in preventing postoperative adhesions. CONCLUSIONS: HAM and Seprafilm proved to be an effective antiadhesive barrier in PPM repair of abdominal wall hernia.

Abdomen↗
PubMed2000

Pelvic actinomycosis presenting as ureteric and rectal stricture.

BACKGROUND/AIMS: Simultaneous ureteric and rectal stricture due to pelvic actinomycosis is very rare and only a few cases of either rectal or ureteric stricture have been reported. Our aim is to report a case of stricture of the rectum and the right ureter due to pelvic actinomycosis infection in a 63-year-old man. METHODS: Explorative laparotomy and biopsies of the inflammatory pelvic mass were the only procedures that led to the definitive diagnosis of actinomycosis. Temporary diverting colostomy, drainage of the right ureter by a pigtail catheter and postoperative treatment with appropriate antibiotics were successful in eradicating the inflammatory process. CONCLUSIONS: Extensive pelvic masses involving pelvic viscera should be biopsied before undertaking any major surgery because of the possibility of pelvic actinomycosis.

Actinomycosis↗
PubMed2000

Distal arterial flow in patients undergoing upper extremity dialysis shunting: a prospective study using doppler sonography.

OBJECTIVE: The objective of this study was to document changes in the distal circulation after creation of a proximal upper extremity dialysis shunt and to correlate these findings with the patient's clinical condition. SUBJECTS AND METHODS: We prospectively examined 18 patients scheduled for upper extremity shunt creation. We used color and spectral Doppler sonography to examine flow in the radial and ulnar arteries, noting flow direction and peak systolic velocity. After the shunt procedure, we repeated the measurements and correlated them statistically with hand symptomatology. RESULTS: Six (33%) of 18 patients were symptomatic. The mean peak systolic velocities in the radial and ulnar arteries were 52 and 61 cm/sec, respectively, before surgery, and decreased to 12 cm/sec after surgery in the radial artery and 44 cm/sec in the ulnar artery. The mean percentage of decrease in peak systolic velocity was 77% in the radial artery and 28% in the ulnar artery. Eight patients showed reversed flow. No statistical correlation was found between change in peak systolic velocity values before and after surgery and the presence of hand symptoms. Similarly, no correlation was found between flow reversal and symptoms. The most consistent factor associated with symptoms was diabetes; all symptomatic patients were diabetic, but only 54% of the diabetic patients were symptomatic. CONCLUSION: The difference in the peak systolic velocities in the radial and ulnar arteries after shunt construction does not correlate with symptoms. The hand can tolerate a significant decrease in the peak systolic velocity and even flow reversal without symptomatology.

Adult↗
PubMed1999

Laparoscopic splenopexy of a wandering spleen.

A laparoscopic technique for splenopexy of a wandering spleen using an absorbable mesh in an adult woman is described for the first time. This patient was referred to surgery because of recurrent biliary colic secondary to cholecystolithiasis. The wandering spleen had been diagnosed at least 4 years earlier, but a conservative approach had been adopted for a symptomless patient. Laparoscopic cholecystectomy was performed concomitantly with splenopexy. Laparoscopic splenopexy seems a feasible and safe procedure, especially when performed by experienced laparoscopic surgeons.

Adult↗
PubMed1997

Laparoscopic management of lumbar hernia.

We describe (for the first time) a laparoscopic approach to repair an acquired superior triangle lumbar hernia in a morbidly obese woman by using prosthetic mesh. Such a technique provides an excellent anatomic view, thus avoiding injury to structures in proximity to the hernia during repair; eventually the well-known advantages of such approach result.

Female↗
PubMed1996

Laparoscopic management of acute cholecystitis. Prognostic factors for success.

BACKGROUND: Laparoscopic cholecystectomy for acute cholecystitis is considered feasible and safe, but it is associated with a higher rate of conversion to laparotomy than elective cholecystectomy because of technical reasons and anatomical changes related to the inflammatory process. The value of several factors that might influence its successful completion has not been studied completely yet, including the role of residents in operating such cases under attending-surgeon surveillance. METHODS: In a retrospective nonrandomized study, the medical charts of 182 patients that were operated for acute cholecystitis (94 of whom via the laparoscopic approach) were studied. The study was also conducted to study the effect of residents as operators. RESULTS: Male sex, duration of right upper abdominal pain, and the severity of the inflammatory process have all been significantly and independently correlated with increased conversion rate to laparotomy. Operation time was not longer than that of the open approach, and hospital stay and complication rate were lower. Operations performed by residents were associated with twofold conversion rate to laparotomy, without increased complication rate (p < 0.012). CONCLUSIONS: Laparoscopic management of acute cholecystitis is feasible and safe. Considering the factors discussed above, lowering the threshold for conversion is necessary in selected cases to maintain low morbidity rate. Integrating laparoscopic cholecystectomy for acute cholecystitis into surgical residency should be studied.

Acute Disease↗
PubMed1995

Plasma nitrate concentrations in neutropenic and non-neutropenic patients with suspected septicaemia.

Nitric oxide (NO) is an important physiological mediator of vascular tone and is thought to be involved in the pathogenesis of septic shock. Plasma nitrate is the stable end product of NO oxidation and in part reflects endogenous NO production. We measured plasma nitrate levels in 47 episodes of suspected septicaemia in 43 in-patients (16 male and 27 female, age 15-63 years). Nitrate concentrations were significantly higher (P < 0.01) compared to healthy controls. Further analysis revealed that significantly elevated levels occurred only in the septic patients who had normal or elevated numbers of neutrophils in the peripheral blood and were hypotensive on presentation. Failure of plasma nitrate concentrations to rise significantly in patients with neutropenia suggests that this cell type may be important in the activation of the arginine-NO system in severe sepsis in man.

Adolescent↗
PubMed1994

Tubal anastomosis in the rat using the tissue adhesive cyanoacrylate (Histoacryl).

n-Butyl-2-cyanoacrylate (Histoacryl) is said to be as effective as microsurgery for tubal anastomosis. In a prospective controlled study at the regional teaching hospital research laboratories, 40 female laboratory rats underwent laparotomy, with ligation of the uterine horns, and reanastomosis by microsurgery or cyanoacrylate tissue adhesive. Main outcome measures were patency of uterine horns following anastomosis, histologic examination of anastomotic sites and pregnancy rate following anastomosis by each of the two methods. Patency rates were 100% with both methods of anastomosis, although foreign-body granulomas were more prominent in horns anastomosed by microsurgery. When cyanoacrylate was used on one horn and the contralateral horn ligated, a 90% pregnancy rate was achieved; when microsurgery was used, the pregnancy rate was 80%. In microsurgically anastomosed tubes there was a longer narrow segment, resulting in a lower number of embryos per rat. Cyanoacrylate tissue adhesive is successful in tubal reanastomosis and has certain advantages over classical microsurgical techniques: fewer foreign-body granulomas occur; there is less narrowing of the uterine horn; less skill is required in its use.

Anastomosis, Surgical↗
PubMed1993

Effect of oxygen tension on activity of antioxidant enzymes and on renal function of the postischemic reperfused rat kidney.

The aim of the present study was to examine the effect of exposing animals to 100% oxygen instead of room air on renal function and endogenous antioxidant enzymes of the postischemic reperfused rat kidney. Superoxide dismutase (SOD), catalase and glutathione peroxidase (GPX) were determined in the homogenate of the left kidney after 45 min of ischemia, caused by clamping the left renal artery, 10 and 90 min after reperfusion while the animals breathed room air or 100% O2. The right kidney served as a control. The possible influence of trapped blood in the clamped kidney was also investigated by the use of a correction factor based on the Hb concentration in the homogenate. The results indicate that such correction is necessary as the blood adds significant antioxidant activity. The activities of all 3 enzymes after 45 min of ischemia decreased significantly in the left (ischemic) compared to the right (control) kidney, to 64% of the control levels for catalase, 58% for SOD and 49% for GPX. After 10 min of reflow, a further decrease in the activities of catalase (to 49%) and of GPX (to 29%) was found. SOD activity, however, increased to 64%. After 90 min of reperfusion, restoration toward normal levels was noticed (SOD activity increased to 70%, catalase to 76% and GPX to 58%). Breathing 100% O2 resulted in a significant decrease in all enzyme activities (to 38.6% for catalase, 45% for SOD and to 27.4% for GPX). This inactivation can be explained by increased reactive oxygen species (ROS) activity during hyperoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Specific IgE response in patients with brucellosis.

In the search to find discriminative serological markers to differentiate between patients with acute brucellosis and those with chronic brucellosis, an enzyme-linked immunosorbent assay (ELISA) was used to determine and compare the brucella-specific IgE response in 80 sera from patients with acute brucellosis, 37 sera from patients with chronic brucellosis, 26 sera from patients with positive blood cultures for bacteria other than brucella and 51 sera from healthy controls. The IgE findings were compared to brucella-specific IgG, IgM, IgA and IgG1-4 demonstrated by ELISA, and to microagglutination test (MAT) results. Elevated (positive) antibrucella IgE titres were detected in 89 and 81% of sera from patients with acute and chronic brucellosis respectively. The predominant antibodies found in patients with acute brucellosis were of the IgG, IgM, IgA, IgE, IgG1 and IgG3 types while in chronic brucellosis IgG, IgA, IgE and IgG4 were found. Although IgE can be detected in patients with brucellosis, it does not discriminate between the acute and chronic stages of the disease.

Acute Disease↗
PubMed1989

Posttraumatic autotransplantation of spleen tissue.

Clinical and laboratory studies have documented high susceptibility to pneumococcal infection in asplenic humans and animals. Splenic autotransplantation has been suggested as a method of preserving function. Autotransplantation of irreparably damaged spleens in humans preserved splenic functions. Ten patients operated on for blunt abdominal trauma required unavoidable splenectomy. In each, autotransplantation of the removed spleen (roughly 50 g) was performed. Postoperative studies of splenic functions revealed disappearance of Howell-Jolly bodies from peripheral blood. Levels of IgM, which were initially significantly depressed, returned to normal and there were normal technetium Tc 99m sulfur colloid scans ten weeks after surgery. All patients are alive and healthy. Our data suggest that autotransplantation of spleen is a safe alternative method for preserving splenic function when total splenectomy is mandatory for hemostasis.

Abdominal Injuries↗