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Biomedical subjects

S Nissan

Publications and source records attributed to S Nissan.

At least 19 recordsLinked to original sources
PubMed1992

Nissen fundoplication in the treatment of children with familial dysautonomia.

Thirty-four children with familial dysautonomia (FD) underwent Nissen fundoplication and gastrostomy. The indications for operation were persistent cyclic vomiting that resulted in repeated aspiration pneumonia (94% of the patients), chronic dehydration (82%), failure to thrive (97%), and frequent hospitalizations (76%). There was no operative or early postoperative mortality. Long-term follow-up for up to 12 years was available. Eight patients died during this period from 7 months to 7.5 years postoperatively. In 5 patients (15% of the operated patients), the fundoplication ceased to function 16 months to 5 years postoperatively, which was attributed mainly to repeated severe dysautonomic crises with vigorous retching. Vomiting ceased in 85% of the symptomatic patients; pulmonary deterioration was halted, and the frequency of aspiration pneumonia was reduced in 68%; nutritional improvement was seen in 44%; the hydration status improved in 88%; and the frequency of hospital admissions decreased in 74%. These long-term findings resulted in a significant improvement in the quality of life for the majority of the patients. The absence of operative mortality and the low postoperative morbidity, together with the long-term beneficial results of this surgical procedure, should encourage early surgical intervention in selected FD patients.

Adolescent↗
PubMed1991

Felix Wurtz: surgeon and pediatrician.

Felix Wurtz, a surgeon in Basel and Zurich, wrote a book on pediatrics, The Childrens Book, which was first published (after his death) in 1612. It is the first known book in western Europe to deal with pediatrics and surgery. The book discusses issues dealing with the care of children, also addressing problems in pediatric surgery, primarily congenital and acquired orthopedic malformations. The book, and the contribution of its writer to pediatric surgery, are reviewed. The accuracy of the first English language translation is also evaluated.

General Surgery↗
PubMed1989

Peritonitis and empyema following the use of dextran in tubal operations.

Two patients developed severe bacterial sepsis with peritonitis and pleural empyema following tubal surgery. Intraperitoneal low-molecular dextran was used in both patients and hydrocortisone was administered perioperatively. The use of dextran in tubal surgery probably increases the risk of severe postoperative infection and should be avoided in susceptible patients. Prophylactic antibiotics may be indicated when dextran is administered.

Adult↗
PubMed1988

Idiopathic gastrointestinal perforation in the neonate.

Spontaneous localized perforation of the gastrointestinal tract, unrelated to mechanical intestinal obstruction and with no evidence of necrotizing entrocolitis (NEC), occurred in 20 neonates. Three perforations were located in the stomach, 11 in the small intestine, and six in the colon. Maternal obstetric complications as well as prematurity and postnatal distress were common in these patients. The overall survival rate was 80%. There was no late gastrointestinal symptoms in the survivors. Whether idiopathic perforation of the gastrointestinal tract results from a localized form of NEC or from a distinct lesion of unknown etiology has not yet been ascertained. Some ideas concerning the etiology of this entity, as well as some diagnostic aspects are discussed.

Colon↗
PubMed1988

Gastrointestinal perforations in the neonatal period.

Forty-eight neonates were treated for gastrointestinal perforation during a 9-year period. In 30, perforation occurred within the first week of life. Thirty-six were preterm infants and many had a history of obstetric and postnatal complications. Perforation resulted from necrotizing enterocolitis in 26 patients, whereas in 14 neonates spontaneous perforation occurred in an apparently normal bowel, with no evident cause (idiopathic perforation). In 6 patients perforation was associated with meconium ileus. Primary closure was carried out for perforations of the duodenum and stomach. Intestinal perforations were usually treated by resection and enterostomies. The overall mortality rate in this series was 46%. The highest mortality rate was associated with necrotizing enterocolitis (62%). The mortality rate was only 14% in patients with idiopathic perforation. Despite improvement in the prognosis of neonatal gastrointestinal perforations in recent years, it is still discouraging, reflecting the difficulty in preventing and treating necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1988

Treatment of faecal incontinence in children with spina bifida by biofeedback and behavioural modification.

Faecal incontinence may lead to serious social and physiological disturbances. Over 90% of patients with spina bifida have varying degrees of neurogenic bowel with disturbances of faecal control. This is a serious habilitation problem in these patients. Three encopretic children with myelomeningocele were treated by Biofeedback operant conditioning and behavioural modification to self-initiate bowel movements. Their neurological levels were T-10; T-11; T-12. Each child had a mean of 10 Biofeedback sessions each of 30-45 minutes, combined with daily behavioural modification. Two patients improved and have voluntary bowel movements. Therapy failed in one patient. We conclude that Biofeedback operant conditioning combined with specific behavioural modification may become a simple technique to treat encopretic patients with meningomyelocele.

Behavior Therapy↗
PubMed1987

Spontaneous perforation of the stomach in the neonate.

Three full-term female neonates developed gastric perforation during their first week of life. All three experienced severe postnatal asphyxia and improved following resuscitation. A linear perforation located in the prepyloric area was found in these patients. Direct closure was successfully performed in all three neonates. Asphyxia seems to be a major predisposing factor in neonatal gastric perforations. Focal gastric ischaemia and acid peptic activity may play part in the pathogenesis in these cases.

Female↗
PubMed1987

Lung resection for bronchiectasis in children.

Twenty children with bronchiectasis underwent pulmonary resections during an 8-year period. All patients suffered from significant symptoms that did not respond to medical treatment and had localised disease. In 7 patients bronchiectasis developed following foreign body aspiration and in two the aetiology was cystic fibrosis and immune deficiency, respectively. The lower lobes were most commonly involved. Atelectasis of the remaining ipsilateral lung was the most common postoperative complication occurring in four patients. One patient required reoperation for recurrent symptoms. Fifteen out of 18 patients who underwent curative resections were asymptomatic in the longterm follow-up. It is concluded that for children with significant symptoms due to localised bronchiectasis that fails to respond to medical treatment, resection of the affected lobes is indicated.

Adolescent↗
PubMed1987

Wide local excision as an alternative treatment for periampullary carcinoma.

Wide excision of periampullary carcinoma is associated with low operative morbidity and mortality, but its effect on long-term survival, compared with that of pancreaticoduodenal resection, is controversial. Five patients with periampullary carcinoma were treated with wide local excision as a definitive procedure. There was no operative death, and four patients survived for two or more years following the operation. These patients are presented and the literature is reviewed.

Adenocarcinoma↗
PubMed1987

Localized pseudomembranous colitis simulating carcinoma of the cecum.

A 76-yr-old woman complained of right lower quadrant abdominal pain, nausea, and fever. There was no history of antibiotic therapy or preceding diarrhea. At laparotomy, a cecal lesion simulating a tumor was found with an otherwise normal colon. Right hemicolectomy was performed. Pathological examination showed pseudomembranous colitis confined to the cecum. It is suggested that pseudomembranous colitis unrelated to prior exposure to antimicrobial agents can occur without diarrhea, and may be a localized process mimicking colonic carcinoma.

Aged↗
PubMed1987

The effect of meperidine on the guinea pig extrahepatic biliary tract.

The effect of meperidine on the mechanical activity of isolated guinea pig common bile duct (CBD) and gallbladder was studied in vitro. The effect was found to consist of inhibitory and excitatory phases. The inhibitory phase, characterized by a decrease in the response of the CBD and gallbladder to carbachol and electrical stimulation, was seen with concentrations of 10(-6) M or higher. The excitatory phase, seen at high concentrations of meperidine (5 X 10(-5)-10(-4) M), involved an increase in spontaneous contractions of CBD and in the tone of the gallbladder. Neither effect of meperidine was affected by 0.5 X 10(-5) M naloxone. These data indicate that meperidine acts on the biliary tract by a mechanism different from that associated with the effect of morphine.

Animals↗
PubMed1987

Effect of morphine on the mechanical activity of common bile duct isolated from the guinea pig.

The contractile response of isolated guinea pigs common bile ducts (CBD) to transmural electrical stimulation and the effects of morphine and naloxone was studied. Contractile responses increased as a function of stimulus frequency. In the absence of naloxone morphine inhibited the contractile response to electrical stimulation in a dose-dependent manner. Naloxone prevented the inhibitory effect of morphine on the contractile response to electrical stimulation. We conclude that smooth muscle of the CBD in guinea pig is functional and can contribute to biliary motility, and that opiate receptors exist in nerve elements in the CBD.

Animals↗
PubMed1986

Phenazine methosulfate induces a neurally-mediated contraction of the guinea-pig ileum.

Phenazine methosulfate (PMS) and related phenazines are widely used in biochemistry and histochemistry and act as anti-bacterial agents, however, there is little information on their pharmacological actions. In the present paper the guinea-pig ileum was used as a model for studying the effects of PMS on nerve cells. PMS was found to contract intestinal muscle. This action appeared to be mediated by the activation of muscarinic receptors since it was blocked by atropine. Neostigmine potentiated the response to PMS. The nerve blocker tetrodotoxin prevented the effect of PMS and it is concluded that PMS causes the release of acetylcholine from nerve elements. The action of PMS on nerves is not mediated by nicotinic receptors. Receptors for serotonin, substance P or cholecystokinin also appear not to be involved. Of all the phenazines tested PMS was found to be the most potent and reversible.

Acetylcholine↗