Biomedical subjects
Publications and source records attributed to N Saad.
We describe a surgical maneuver suitable for stenosis of the bifurcation of the right coronary artery. The distal end of a saphenous vein graft is prepared to obtain a two-headed shape. The anastomosis achieves enlargement of the bifurcation, providing complete distal revascularization.
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Isolated third nerve paresis is a rare diagnosis among patients presenting to the Botulinum Toxin Clinic at Moorfields Eye Hospital. Ten patients with this diagnosis are reviewed in this study. Head trauma is a common cause of third nerve palsy and is often severe enough to cause damage to fusion potential. If fusion is present and there is adequate adduction of the divergent eye, then botulinum toxin injection of the lateral rectus may induce long-term control of the ocular deviation. Three of the four patients who experienced long-term control of their ocular deviation following toxin injection shared these features. Toxin injected into the lateral rectus did not, however, reliably assess medial rectus function and therefore predict the outcome of horizontal squint surgery. Reasons for this are discussed.
One hundred patients underwent coronary revascularisation with both internal mammary arteries between 1987 and 1990. The average age of the patients was 55 years. The left internal mammary was used in 97 of the 100 cases as a pediculated graft to revascularise the left anterior descending (66 cases), left lateral (27 cases) or a bissecting artery (4 cases). The right internal mammary was used as a pediculated graft in 51 cases and as a free graft to revascularise a left lateral (51 cases), left anterior descending (29 cases) or right coronary artery (20 cases). There was one death in the first 30 postoperative days. Morbidity was low with no cases of sternal infection. The average postoperative bleeding was 633 +/- 550 ml per patient. The incidence of phrenic nerve paralysis decreased from 36% in the first 50 patients to 6% in the second 50 patients. Angiography at the 10th postoperative day showed 4 occlusions out of 132 internal mammary arteries opacified (97% patency). Ninety four patients are asymptomatic and have negative exercise stress tests. Mortality and morbidity of coronary surgery using the two internal mammary arteries are therefore the same as those of conventional coronary surgery using saphenous veinar only one internal mammary artery, providing that it is reserved for patients in good general condition, under 65 years of age, without obesity or diabetes. This technique of coronary artery revascularization should provide better long-term results because of the high patency rate of the grafts.
In recent years, there has been great interest in recording the pattern electroretinogram (PERG) in glaucomatous and diabetic populations. The Dawson, Trick, and Litzkow thread electrode (DTLTE) and the gold foil electrode (GFE), commonly used for recording PERGs, were compared for variations in amplitude of response, test-retest variability, and patient comfort. Two study centers collected data on a total of 32 normal subjects. The subjects from the London center showed a slight (but not significant) preference for the DTLTE, and the Houston subjects also found the DTLTE to be significantly more comfortable (chi-square = 39, P less than 0.001). In both study groups, the GFE was found to produce a statistically larger amplitude of response than that obtained with the DTLTE. Significant differences were found regardless of the slow (transient, 3.1 Hz; F = 6.24; P = 0.0192) or fast (steady state, 8.3 Hz; F = 18.38; P = 0.0001) stimulus-presentation rate. Larger differences between the two electrodes occurred under steady-state conditions. Although there is no consensus as to the optimum recording conditions to obtain the subtle PERG, it appears the the GFE records larger responses than the DTLTE. However, test-retest data confirmed that the GFE records twice the amplitude of the DTLTE, and it also produced twice the variability (average percent difference over time for GFE, 15%; for DTLTE, 8%).
We report two cases of diffuse neonatal haemangiomatosis. The multiple cutaneous lesions were associated with massive hepatic involvement and congestive heart failure in one, while in the other laryngeal haemangiomas caused stridor and inspiratory distress. A significant regression in vascular lesions was achieved with high dose corticosteroid therapy.
A local virulent strain, VLT, of Newcastle disease virus formed 3- to 4-mm plaques on monolayers of primary chicken embryo cultures on the 4th day after inoculation. It agglutinated chicken and human 0 erythrocytes. Its hemagglutinin was stable at 56 C when compared with those of Komarov (K) and F vaccinal strains of the same virus. The viral titer of infected allantoic fluid dropped from 10(8.1) plaque-forming units to 10(1.0) plaque-forming units/ml within 2 hours when incubated at 56 C. The strain was ether-sensitive; it adsorbed readily on monolayers of chicken embryo cells and did not diffuse through agar. Its intracerebral pathogenicity index, chicken dose LD50, and embryo mean death time (hours) were 1.8, 9.0, and 48, respectively. Two virulent strains isolated in 1974 and 1975 were found to be identical to the VLT strain in terms of certain physical and biological properties. On the basis of plaque morphologic characteristics, hemagglutination spectrum, and hemagglutinin inactivation at 56 C, it was possible to identify readily the field isolate when it was compared with vaccinal strains (K and F) commonly used in Lebanon.
The case is described of a 22-year-old man who presented with ulcerative keratitis as a complication of conjunctivitis that was caused by penicillinase-producing Neisseria gonorrhoeae. The need for first-line treatment with antibiotic agents that are resistant to beta-lactamase breakdown is discussed.