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Biomedical subjects

M Milad

Publications and source records attributed to M Milad.

At least 19 recordsLinked to original sources
PubMed2001

Resident training and endoscopic hospital privileging.

Laparoscopic techniques were originally confined to female sterilization. As both instrumentation and methodology improved, gynecological endoscopy was applied to more complex processes, including salpingostomy or salpingectomy for ectopic pregnancy, and ovarian cystectomy or oophorectomy for benign conditions. Now, the laparoscopic treatment of adhesions, endometriosis and hysterectomy is almost commonplace. More sophisticated endoscopic procedures include the management of pelvic floor disease, incontinence and malignancies. However, at least two problems have become readily apparent: (i) there is often limited basic laparoscopic and hysteroscopic teaching during residency and fellowship training; and (ii) there is no standard by which to privilege or train physicians who may not have had any significant endoscopic training during residency. In this article we describe current learning theories and identify goals and specific objectives for residents in implementing a successful training program. We also discuss the mechanisms by which to privilege attending staff for gynecological procedures and the important clinical outcomes that can be improved. Finally, we raise concerns about creating algorithms by which to renew clinical privileges in endoscopic procedures.

Female↗
PubMed1999

Heavy metals, lipid peroxidation, and ciguatera toxicity in the liver of the Caribbean barracuda (Sphyraena barracuda).

Human consumption of over 400 species of tropical fish containing polyether toxins (e.g. ciguatoxins, maitotoxins) causes ciguatera fish poisoning. The Caribbean barracuda (Sphyraena barracuda) is one of the most potent ciguatoxic fish. The objective of this study was to determine whether toxicity of 14 barracuda livers was correlated with lipid peroxidation. A significant correlation (p = 0.015, Pearson's correlation) between lipid peroxidation and toxicity of barracuda liver was found. Because iron and copper are well-known catalysts of hydroxyl radical production and lipid peroxidation in biological systems, the correlation between the concentrations of these metals in barracuda liver and lipid peroxidation and toxicity was also investigated. Cadmium was significantly correlated (p = 0.014) with the toxicity of barracuda livers. This study provides the first data concerning the concentration of iron, copper, and cadmium in the liver of the Caribbean barracuda. Of the three metals studied in barracuda liver, iron was the most abundant, followed by copper and cadmium. Lipid peroxidation was highly variable and detected in five (36%) of the liver samples. Lipid peroxidation was not statistically significantly correlated (p > 0.05) with concentrations of iron, copper, and cadmium in barracuda liver. Collectively, these findings provide additional evidence that lipid peroxidation can be a mechanistic component of ciguatera toxicity in the Caribbean barracuda.

Animals↗
PubMed1998

Laparoscopic Irving tubal sterilization. A case report.

BACKGROUND: Very little literature exists on the surgical management of failed tubal ligation. However, a review of the literature confirms that the failure rate of an Irving tubal sterilization is far lower than is associated with partial salpingectomy or unipolar coagulation. CASE: A laparoscopic Irving procedure was performed in a woman whose postpartum partial salpingectomy failed. CONCLUSION: To our knowledge, this is the first report of an Irving sterilization performed by laparoscopy. Laparoscopic Irving tubal sterilization can be an effective alternative to fimbriectomy or salpingectomy for failed primary tubal sterilization.

Adult↗
PubMed1997

Successful early intervention in air embolism during hysteroscopy.

Hysteroscopy is used as a diagnostic tool for intrauterine pathology. Gas embolism with air or carbon dioxide is a rare but sometimes fatal complication of laparoscopy or hysteroscopy. We present a patient who developed pulmonary air embolism during hysteroscopy that caused a noncardiogenic pulmonary edema in the recovery room. This case report emphasizes that early intervention can prevent life-threatening events associated with pulmonary embolism during hysteroscopy. Pathophysiology of pulmonary gas embolism, as well as that of noncardiogenic pulmonary edema, is discussed. A protocol for the prevention, early detection, and management of this emergency is provided.

Adult↗
PubMed1995

Interaction of the progesterone receptor with binding proteins for FK506 and cyclosporin A.

T47D human breast carcinoma cells and the chicken oviduct were used to study the structure of the nonactivated progesterone receptor (PR) complex. Immunoprecipitation of PR (B form) from cytosol extracts was performed using monoclonal antibody PR6, a cross-reactive antibody prepared to chicken PR. Analysis of the PR complex by sodium dodecyl sulfate gels and Western immuno-blotting revealed the presence of several specific copurifying proteins. Consistent with previous reports, the two heat shock proteins, hsp90 and hsp70, were shown to be present. A third 59-kilodalton (kDa) protein observed previously was confirmed to be p59 (also called hsp56 or FKBP52), which has been shown to bind the immunosuppressant drug FK506. Two additional PR-associated proteins were observed that had not been previously recognized with human PR. These have molecular masses of 54-kDa and 23-kDa and have been shown by Western blotting to be related to the proteins p54 and p23 that are associated with chicken PR. P23 is a novel protein of unknown function and p54 or FKBP54 has been recently shown to be another FK506-binding protein related to p59. Finally, the cyclosporin A-binding protein, CyP-40, could be detected in isolated chicken PR complexes and in PR complexes that were reconstituted in vitro, but this protein was not detected in human PR complexes, which are less stable than chicken PR complexes in cytosol extracts. The functional significance of FK506 and cyclosporin A-binding proteins to hormone action was tested using a T47D cell line that contained a progestin reporter gene, MMTV-CAT. Treatment with cyclosporin A had no effect on the basal level of CAT expression, but it caused a dramatic increase in the sensitivity and magnitude of the response to the synthetic progestin, R5020. The enhanced response elicited by drug treatment was blocked by the antiprogestin RU486 indicating that this effect was receptor-mediated. While cyclosporin A enhanced progestin action in T47D cells, it inhibited a PR/reporter gene system in L cells. The drugs FK506 and rapamycin had no effect on progestin action in T47D cells, but they stimulated glucocorticoid action in T47D cells. Thus, the effects of these immunosuppressant drugs vary with the cell type and hormonal system that is tested. Whether these drug effects relate directly to the immunophilins bound in receptor complexes remains unknown.

Animals↗
PubMed1992

Iron status in low-birth-weight infants, small and appropriate for gestational age. A follow-up study.

Iron nutrition was measured in 84 low-birth-weight infants. At birth, they were assigned to three groups: preterm infants appropriate for gestational age (n = 29); preterm infants small for gestational age (n = 17); and full-term infants small for gestational age (n = 38). A sub-sample of infants was supplemented with iron 3 mg/kg from two to four months of age. At birth, preterm appropriate-for-gestational-age infants had a lower hemoglobin concentration than full-term small-for-gestational-age infants (p < 0.01) and a higher serum ferritin than preterm small-for-gestational-age infants (p < 0.05). In the non-supplemented group, full-term small-for-gestational-age infants had significantly higher hemoglobin concentrations at four months of age. At this age, iron-supplemented preterm infants appropriate or small for gestational age had significantly higher hemoglobin levels than non-supplemented subjects, while iron supplementation did not have an effect on final hemoglobin concentration in full-term small-for-gestational-age infants. We conclude that preterm infants, irrespective of their adequacy for gestational age, show evidence of iron deficiency before four months of age. Full-term infants do not develop iron deficiency up to this age.

Anemia, Hypochromic↗
PubMed1989

Characteristic sonographic pattern of schistosomal hepatic fibrosis.

The hepatic sonographic patterns from 50 patients undergoing operations for bleeding esophageal varices were compared with the interpretation of the histological findings in a hepatic wedge biopsy obtained during surgery. The sonographic pattern for schistosomiasis periportal fibrosis is characteristic and is not mimicked by other hepatic diseases we have studied. Sonography agreed with pathology in 44 out of 50 patients. Schistosomiasis could be separated from cirrhosis, as well as from combined lesions. Where there was a discordance, we believe that sonography gave a more accurate diagnosis.

Adult↗
PubMed1981

Resonance Raman spectra for flavin derivatives modified in the 8 position.

Spontaneous resonance Raman or resonance-enhanced AC-coupled inverse Raman spectra were obtained for 8-mercaptoriboflavin, 8-(dimethylamino) riboflavin, 8-hydroxyriboflavin, and 8-aminoriboflavin all free in solution. These Raman spectra were all similar to one another and markedly different from that of riboflavin. In addition, the Raman spectra of 8-mercaptoflavin bound to the apoproteins of old yellow enzyme, glucose oxidase, and L-lactate oxidase were determined. The Raman spectra of these protein-bound flavins were distinctly different from both those of the above 8-substituted riboflavins and that of riboflavin. An argument is presented in favor of assigning a quinonoid electronic structure to these protein-bound flavins.

Flavins↗
PubMed1981

Pathogenesis of juvenile nasopharyngeal fibroma. (A new concept).

Fifteen cases of juvenile nasopharyngeal fibromata have been studied clinically and histologically, and their structure has been compared to that of genital erectile tissue obtained from autopsies of foetuses and children. A similarity in the structure of these two tissue could be observed. A concept of juvenile nasopharyngeal fibroma as arising from misplaced sequestrated genital erectile tissue during foetal development, is discussed; and support is given to this view by anatomical, clinical and histological data.

Adolescent↗
PubMed1979

Renal amyloidosis and schistosomiasis.

A retrospective study of 60 renal biopsies obtained from nephrotic subjects with schistosomiasis showed amyloid deposits in 10 cases. Distribution was usually segmental, mainly mesangial and overlapped with the conventional mesangio-proliferative lesions of schistosomiasis. The invariable clinical presentation was proteinuria with generalized oedema of insidious onset and a slowly progressive or intermittent course. Differences from conventional schistosomal nephropathy are described. Response to anti-schistosomal treatment was very poor. Repeat renal biopsies showed no regression of the lesions. The possible links between schistosomiasis and amyloidosis are discussed and causes of amyloid deposition suggested.

Adolescent↗
PubMed1977

Lupus nephritis.

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Adolescent↗