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Biomedical subjects

N Habib

Publications and source records attributed to N Habib.

At least 55 records · Page 3Linked to original sources
PubMed1994

Liver resection with total vascular exclusion for malignant tumours.

The records of 47 patients with no cirrhosis who underwent 56 liver resections under total vascular exclusion (TVE) for malignant tumours, both primary and secondary, were reviewed to study the effects of TVE. The mean (s.e.m.) blood loss was 1651(233) (median 1200 (range 200-8500)) ml and the mean(s.e.m.) intraoperative blood transfusion 930(100) (median 700 (range 0-2800)) ml. In 18 liver resections (32 per cent) no blood transfusion was administered. The mean(s.e.m.) postoperative hospital stay was 19.7(14.2) days. The 30-day operative mortality rate was nil but the hospital mortality rate was 4 per cent. Postoperative prothrombin time was influenced by the amount of liver resected and the duration of TVE but not by the amount of blood transfused. Postoperative serum levels of aspartate aminotransferase and bilirubin were not influenced by either the amount of liver resected or the duration of TVE.

Adult↗
PubMed1994

Liver function improvement following increased portal blood flow in cirrhotic rats.

BACKGROUND/AIMS: Liver microcirculation in cirrhosis is characterized by development of intrahepatic shunts and capillarization of sinusoids secondary to cell necrosis and deposition of new collagen, resulting in both decreased drug elimination and increased vascular resistance with portal hypertension. The aim of this study was to examine the effects of increased portal blood flow on hepatic microcirculation and drug elimination in 13 perfused livers from cirrhotic rats. METHODS: Intrahepatic resistance was assessed under basal conditions (21.2 +/- 0.3 mL/min) and 1 hour after doubling the flow (41.6 +/- 1.0 mL/min). A multiple indicator dilution technique was used at both flow rates to measure sinusoidal volume, albumin and sucrose extravascular volumes, and cellular water volume. Hepatic elimination of labeled taurocholate and propranolol was also measured, and the recovery of 15-microns microspheres was used to evaluate large intrahepatic shunts. RESULTS: After doubling the flow, intrahepatic resistance decreased by 31%. Sinusoidal and extravascular volume increased significantly without a change in microsphere recovery. However, there was a marked increase in taurocholate and propranolol elimination by cirrhotic livers. Moreover, during high flow, significant correlations were found between changes in albumin extravascular volume and taurocholate and propranolol elimination. CONCLUSIONS: Increased portal blood flow in cirrhotic rats induces a decrease in intrahepatic resistance without changes in intrahepatic shunting and improves drug elimination by the liver without deleterious effects on hepatocyte viability.

Animals↗
PubMed1994

Expression of hepatocyte growth factor mRNA, and c-met mRNA (hepatocyte growth factor receptor) in human liver tumours.

We have quantified mRNA for the hepatocyte growth factor and its putative receptor the c-met proto-oncogene protein product, in a series of human primary and secondary liver tumours and adjacent non-neoplastic liver. In all hepatocellular cancers, hepatocyte growth factor 6 kb mRNA expression was less (mean 23.93% +/- 6.33% S.E.M. n = 7) in the tumours than in the adjacent normal liver. Both relative over- and under-expression of c-met transcripts were found in tumour tissue compared to non-neoplastic liver. Thus hepatocellular cancer tissue does not over-express mRNA for hepatocyte growth factor, though this growth factor might play a role in hyperproliferative states leading to liver cancer.

Adenoma↗
PubMed1993

Augmented portal flow in the isolated perfused cirrhotic rat liver: a haemodynamic and morphological study.

1. Isolated perfused cirrhotic rat livers were used to study the effects of an increase in portal perfusion pressure and portal flow on the microcirculation and viability of the hepatocytes. Cirrhosis was induced by CCl4, and Krebs-Ringer bicarbonate buffer solution was used as the perfusate. Portal perfusion pressures were increased incrementally between 25 and 45 cm H2O. The viability of the livers was assessed and histological studies were performed under light and electron microscopy. 2. An increase in portal perfusion pressure induced an increase in hepatic flow in all the experiments (P < 0.05). Hepatic flow was 2.52 ml min-1g-1 of liver (SD 0.67; n = 5) at basal pressure compared with 4.19 ml min-1g-1 of liver (SD 0.93; n = 5) and 5.91 ml min-1g-1 of liver (SD 0.63; n = 5) when pressures were raised to 25 and 45 cmH2O, respectively. Portal perfusion pressure and hepatic flow were correlated (r = 0.908; P < 0.001; n = 30). 3. Production of the enzyme alanine aminotransferase (EC 2.6.1.2) increased significantly from 5.69i.u. ml-1min g-1 of liver (SD 3.62; n = 5) to 23.53i.u. ml-1min g-1 of liver (SD 16.7; n = 5) when the perfusion pressure was raised from baseline to 30 cmH2O. In all the cases the porto-caval gradient of enzyme production was within the normal range. No correlation existed between the release of enzyme and portal perfusion pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Conservative management of splenic subcapsular hematoma in the third trimester of pregnancy. A case report.

A delayed splenic hemorrhage from a subcapsular hematoma occurred in association with pregnancy. That rare complication carries a high mortality rate, is rarely diagnosed preoperatively and is correctly diagnosed only 20% of the time. The clinical setting and a high index of suspicion led us to investigate for the presence of a splenic hematoma. A computed tomographic scan was invaluable in establishing the diagnosis. We adopted a conservative approach and followed the patient's clinical course from 28 to 40 weeks' gestation, until she delivered vaginally. In general, patient management (conservative vs. splenectomy) and mode of delivery will depend on how close one is to the initial event, on the patient's and fetus's clinical condition and on the gestational age.

Accidents, Traffic↗
PubMed1991

Experimental reduction of portal hypertension by mechanical increase of liver portal flow.

Studies on the isolated perfused rat liver demonstrated that an increase in portal pressure is associated with an increase in the portal blood flow in normal and in cirrhotic livers. In two pigs with portal hypertension mesenteric portal pressure was lowered by mechanically increasing the liver portal blood flow by means of a balloon pump around the portal vein.

Animals↗
PubMed1991

Surgical emergencies in liver disease.

In this chapter the surgical management of bleeding oesophageal varices, ruptured hepatocellular carcinoma and fulminant liver failure have been discussed. Bleeding oesophageal varices can usually be successfully treated with vasopressin, balloon tamponade and injection sclerotherapy. Emergency surgery should be considered if two courses of injection sclerotherapy have failed to achieve haemostasis. Stapled oesophageal transection and portosystemic shunting are currently the two most popular procedures. The former is associated with a lower morbidity and mortality as well as a lower incidence of subsequent encephalopathy. Ruptured hepatocellular carcinomas are usually associated with liver cirrhosis and impaired liver function. Selective coeliac axis cannulation followed by embolization of the hepatic artery branches supplying the tumour is an effective method of achieving haemostasis and is associated with a lower morbidity and mortality than emergency hepatic artery ligation or liver resection. If haemostasis is achieved by embolization the patient may subsequently be assessed for an elective resection of the tumour. Fulminant liver failure may be managed by supportive medical therapy or orthotopic liver transplantation. Patients whose liver failure is graded as mild (grade I) should be treated by medical therapy, whereas those with severe liver damage (grades III and IV) should be assessed for transplantation. Accurate monitoring of the patient's clinical progress and prognostic indicators are vital in deciding whether conservative treatment should be continued or liver transplantation performed.

Carcinoma, Hepatocellular↗
PubMed1991

Hepatolithiasis associated with anomalous biliary anatomy and a vascular compression. Hepatolithiasis and anomalous anatomy.

Biliary tract abnormalities occur in about one of every three people, usually being minor and of no clinical significance. Major abnormalities, however, may present in an unusual manner and provide a major hazard to the unsuspecting surgeon. A patient presenting with cholangitis without jaundice or abnormal liver function tests is reported. Endoscopic retrograde cholangiography failed to demonstrate any bile ducts in the right postero-lateral segments of the liver, the "naked segment sign". A percutaneous transhepatic cholangiogram demonstrated a stricture obstructing the right posterior segmental hepatic duct with hepatolithiasis above the stricture. At operation an anomalous vessel was found at the site of the stricture. This case highlights the unusual way in which biliary tract anomalies may present and the importance of adequate pre-operative investigation.

Aged↗
PubMed1991

Controversy in the management of cholangitis secondary to hydatid daughter cysts.

A 36 year old Cypriot woman, resident in the U.K. since the age of three years, presented with pyrexia, jaundice and upper abdominal pain. On ultrasound examination the biliary tree was dilated, contained sludge and a cystic lesion was present in the liver. An endoscopic cholangiogram showed multiple filling defects in the bile duct which were not felt to be removable endoscopically and a nasobiliary drain was therefore inserted. On resolution of the cholangitis with drainage and antibiotics a laparotomy was performed. The right lobe of the liver was largely replaced by a multiloculated cyst and the bile duct contained multiple hydatid daughter cysts. A right hepatectomy was performed with t-tube drainage of the evacuated bile duct. She made an uneventful recovery and has had no problems on subsequent follow up. Histology confirmed an intrabiliary rupture of a hydatid liver cyst. Cholangitis secondary to daughter cysts is a rare but recognised complication of hydatid liver cysts. Management of hydatid liver cysts by formal resection is controversial but may be preferable in this situation.

Adult↗
PubMed1989

Atenolol for the prevention of arrhythmias following coronary artery bypass grafting.

Seventy patients undergoing aortocoronary bypass grafting were randomized, double-blind, to receive either atenolol or placebo. There were 35 patients in each group. Patients received either atenolol 5 mg intravenously or matching placebo within 3 h of the completion of surgery. A second intravenous dose was administered 24 h following the first and then atenolol 50 mg orally or matching placebo was given for six days. Continuous Holter monitor recordings were obtained for the 24 h immediately preoperatively and continuously for eight days postoperatively. No patient received any antiarrhythmic drug preoperatively. Patients who required pharmacological intervention for the management of postoperative arrhythmias were withdrawn as treatment failures. Holter monitor analysis continued for 24 h following withdrawal of a treatment failure. All patients were analyzed according to the intention-to-treat principle. Both groups were comparable with respect to age, sex, severity of coronary artery disease, left ventricular ejection fraction, preoperative use of beta-blockers, bypass time, aortic cross-clamp time, number of grafts per patient and frequency of preoperative arrhythmias. Arrhythmia analysis was done manually. Supraventricular arrhythmias (atrial tachycardia, atrial fibrillation and atrial flutter) were classified as either mild (less than 0.5 mins, less than 140 beats/min), moderate (0.5 to 30 mins, 140 to 180 beats/min), or severe (longer than 30 mins, more than 180 beats/min). Ventricular arrhythmia analysis was performed with respect to isolated PVCs, couplets, triplets and episodes of nonsustained ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Intraoperative ultrasonographic study of the liver. Methods and anatomic results.

In this study, we have reported our experience with the use of intraoperative ultrasonography in the field of liver surgery. Using the method, the intrahepatic segmental pedicles can be precisely located and thus, segmentectomies can be performed in an anatomic way. The technique allows the most economic parenchymal resection in cirrhotic patients which may be important for prevention of postoperative liver insufficiency.

Bile Ducts, Intrahepatic↗
PubMed1985

Decreased biliary excretion of piperacillin after percutaneous relief of extrahepatic obstructive jaundice.

The biliary excretion of piperacillin has been assessed in 11 patients with obstructive jaundice due to hilar cholangiocarcinoma. After a 1-g intravenous dose administered 30 min before preliminary percutaneous transhepatic cholangiography, no drug was detected in the bile of seven patients; in four others, drug concentrations were far below the corresponding level in serum. After a period of external biliary drainage of up to 28 days, levels of antibiotic in bile after intravenous administration were only minimally increased. The results suggest that although the impairment of hepatic function may be improved by external biliary decompression when assessed by a fall in plasma bilirubin, the biliary elimination of piperacillin and related beta-lactam antibiotics may remain impaired for prolonged periods.

Adult↗
PubMed1984

A histochemical method that predicts local recurrence after curative resection in carcinoma of the colon and rectum.

In an attempt to develop a method to predict local recurrence that may occur following radical resection for cure in patients with carcinoma of the colon and rectum, we have studied retrospectively the histochemical characteristics of mucins in 48 surgically resected specimens. This differential pattern of mucus production at the resection margin distinguished between the patients who had local recurrence develop and those who remained tumor free.

Colonic Neoplasms↗
PubMedDate not supplied

[The evaluation of humoral immunity response in subacute sclerosing panencephalitis (SSPE)].

The purpose of the study was the assessment of humoral response markers in 20 patients with SSPE in phase I, II and III of the disease during immunomodulating treatment. In the CSF IgG levels were determined by nephalometric method, with its share in the total protein level, and with determination of the local IgG synthesis in CNS by Reiber method, 24-hour IgG synthesis by Tourtellotte-Boce method, IgG index by Link-Tibbling method and albumin index. Oligoclonal IgG was determined by isoelectrofocusing. All mathematical tests indicating IgG synthesis in CSF were abnormal in all cases, and also in all cases oligoclonal IgG was found (type 3 of electrophoresis separation pattern). The results point to far reaching changes of the humoral immune response in SSPE persisting also during immunomodulating treatment independently of disease phase and duration. In only 10% of cases abnormal values of the albumin index suggested damage to the blood-brain barrier.

Adolescent↗