PubMed Health⌕ Search

Biomedical subjects

S S Gholami

Publications and source records attributed to S S Gholami.

6 recordsLinked to original sources
PubMed2002

Surgical management: saphenous vein grafts.

Peyronie's disease is a medically and surgically challenging condition to manage. Most surgical techniques to correct the penile deformity often shorten the penis and do not address the issue of hourglass deformity when present. We describe our indications, rationale and technique for the use of a saphenous vein graft after a curvature correcting plaque incision. In reviewing multiple series, this approach yields similar results-incidence of residual curvature: 4-20%, decreased potency: 5-20%, penile shortening: 17-40%. While harvesting the vein would require a second incision, the use of autologous vein appears to be associated with the least amount of intracavernosal fibrosis. We propose that saphenous vein is currently the best material available for tunical patching. The technique and results of circular venous grafting for patients with severe penile shortening secondary to Peyronie's disease is also discussed.

Humans↗
PubMed2001

Radially expanding laparoscopic access for renal/adrenal surgery.

OBJECTIVES: To use a radially expanding system (Step) and a modified port location for intra-abdominal access to decrease the access-related complications in renal and adrenal surgery. Access-related complications during laparoscopic renal surgery are frustrating and are more common in patients with previous abdominal surgery and associated adhesions. METHODS: Laparoscopic upper tract procedures were performed in 62 patients using radially expanding trocars, and the results were reviewed with regard to access, port placement, and associated complications. For initial access, a Veress needle was placed subcostally in the midclavicular line. An expandable mesh sleeve trocar was used for trocar insertion after a pneumoperitoneum was established. A blunt-tipped fascial dilator was used to dilate to 10 or 12 mm. Additional ports were placed in an L shape (nephrectomy) or a subcostal configuration (adrenalectomy) under direct vision using the Step ports. RESULTS: Of 62 patients, 24 had had prior abdominal surgery. Open insertion of the mesh sleeve was necessary in 20%, of whom 60% had had prior abdominal surgery. In 9% of cases, the liver was punctured with the initial pass of the Veress needle. Only minimal bleeding from the injury site was noticed. The liver punctures did not require cauterization and did not result in conversion to an open procedure. At a mean follow-up of 12 months, no access-related complications or port-site hernias were noted. CONCLUSIONS: Placement of the initial access subcostally at the level of the midclavicular line helps to prevent visceral injury, especially in patients with previous abdominal surgery. The use of the radially expanding access system with the modification of port location allows safe and rapid laparoscopic access for upper urinary tract surgery. This trocar system is an excellent alternative to the standard laparoscopic trocars.

Adrenal Glands↗
PubMed2001

Peyronie's disease.

Peyronie's disease remains one of the most perplexing diseases in urology. With continued basic research in wound healing and scarring, the understanding and management of this frustrating disease will improve. Initial treatment of Peyronie's disease should be conservative, with expectant therapy and medical management. Once the penile curvature and plaque have stabilized, patients with severe deformity can be offered surgery depending on their symptoms and complaints. Patient selection is the key to proper treatment. Less experienced surgeons should limit themselves to medical management or simple surgical management of the disease, including plication or Nesbit procedures. Penile-lengthening procedures or the placement of complicated penile prosthesis should be reserved for surgeons with familiarity and expertise in this type of reconstruction. Education on the pathogenesis and natural history of the disease will allow the patient and his partner to make an informed decision in regards to treatment options and expected outcomes.

Humans↗
PubMed2001

The laparoscopic cigarette sponge.

PURPOSE: Minor hemorrhage during laparoscopic procedures may obscure the operative field. We describe the use of an especially designed, 4 x 4 absorbent sponge for multiple laparoscopic applications. MATERIALS AND METHODS: The cigarette sponge, also known as the Kittner roll gauze, was routinely used for laparoscopic upper tract procedures. The sponge may be placed easily through ports 5 mm. or greater. RESULTS: The cigarette sponge was excellent for absorbing minor but bothersome bleeding, facilitating suction and blunt dissection, and assisting with retraction. CONCLUSIONS: This especially designed laparoscopic sponge dramatically eases laparoscopic procedures, especially for controlling bothersome hemorrhage and blunt dissection. It may decrease operative time and facilitate difficult laparoscopic procedures.

Hemostasis, Surgical↗
PubMed1993

Detection of hormone-sensitive lipase in various tissues. II. Regulation in the rat testis by human chorionic gonadotropin.

Hormone-sensitive lipase (HSL) is an intracellular neutral lipase found in a variety of tissues, primarily in adipose and steroidogenic tissues, that hydrolyzes triglycerides and cholesteryl esters. In the rat testis steady-state levels of HSL mRNA increase dramatically during sexual maturation. In addition, HSL-like immunoreactive proteins of 84, -89, and -102 kD have been observed in sexually immature rats with additional -113 and -127 kD immunoreactive proteins expressed in mature animals. In the present studies the ability of human chorionic gonadotropin (hCG) to regulate the expression of HSL and HSL-like immunoreactive proteins in rat testes has been examined. Treatment of sexually immature rats with daily injections of hCG caused a gradual increase in HSL activity that reached an 80% rise (P < 0.01) after 5 days. This was paralleled by a 3-fold increase (P < 0.01) in the 84 kD protein representing the active HSL enzyme. The -89 kD immunoreactive protein was also increased -5-fold (P < 0.01) in parallel to the 84 kD protein and HSL activity. The -102 kD immunoreactive protein was increased by hCG treatment (P < 0.01); however, its expression did not follow changes in HSL activity or in the 84 and -89 kD immunoreactive proteins, peaking within 12 h and declining thereafter. The -113 and -127 kD immunoreactive proteins did not appear during the 5 days of hCG treatment. Steady-state levels of HSL mRNA increased 60-100% (P < 0.02) in parallel to the changes in HSL activity and in the 84 and -89 kD immunoreactive proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗