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Biomedical subjects

Solly Mizrahi

Publications and source records attributed to Solly Mizrahi.

14 recordsLinked to original sources
PubMed2006

Laparoscopic cholecystectomy for acute cholecystitis in patient with situs viscerum inversus.

Situs viscerum inversus is a rare condition with perfect mirror image organs position. Despite the well-described existence of this condition, the implication for the treating of emergency pathology can be important following to the difficult interpretation of signs and symptoms. We report a case of acute cholecystitis in patients with known dextrocardia who was successfully treated by laparoscopic cholecystectomy. The diagnostic problems and surgical technique pitfalls are discussed.

Cholecystectomy, Laparoscopic↗
PubMed2006

Laparoscopic gastric banding in adolescents.

BACKGROUND: Adolescent obesity has undesirable short- and long-term effects. Laparoscopic adjustable gastric banding has been considered a procedure of choice for adolescent morbid obesity. We retrospectively evaluated our single-team banding experience in the adolescent population. METHODS: We reviewed the medical and clinic records and conducted telephone questionnaire interviews, to evaluate the results of banding using the Swedish adjustable gastric band (SAGB) in the 60 adolescents at our institution who had been followed > or =3 years. RESULTS: An average of 39.5 months of follow-up has been conducted in the patients who have been followed > or =3 years. Mean age at the time of the operation was 16 years (9 to 18). 60% reported a family history of obesity. Associated co-morbidities included hypertension, diabetes, sleep apnea and asthma. Mean preoperative BMI was 43 (35-61) kg/m(2). Mean postoperative BMI after 39.5 months follow-up was 30 (20-39) kg/m(2). No co-morbidities have existed after the operation. 6 patients (10%) underwent band repositioning and 2 patients underwent band removal, due to slippage; 7 of the 8 slippages occurred with an earlier perigastric technique which transgressed lesser sac. There was no mortality. Average postoperative hospital stay was 24 hours. CONCLUSIONS: Gastric banding in adolescents is a safe, satisfactory and reversible weight reduction procedure.

Adolescent↗
PubMed2005

Primary aortoduodenal fistula: Pitfalls and success in the endoscopic diagnosis.

Primary aortoenteric fistula is a rare but catastrophic cause of gastrointestinal bleeding. The diagnosis of primary aortoenteric fistula is difficult to make and is usually accompanied by a very high level of clinical suspicion. It should be considered in any elderly patient presenting with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. Prompt surgical intervention is necessary. We present the case of a 78-year-old man with a history of atherosclerotic abdominal aortic aneurysm which is presented with massive upper gastrointestinal bleeding due to a primary aortoduodenal fistula. Initial misdiagnosis led to a delay in treatment and the patient succumbed to the illness.

Journal Article↗
PubMed2005

A minimally invasive solution for necrotic fundus following slipped adjustable gastric band.

The laparoscopic adjustable gastric band (LAGB) is widely used for treatment of morbid obesity. Band slippage is a well known long-term complication. Herein, we present a patient with band slippage who developed strangulation of the fundus with irreversible necrosis. The chosen surgical solution was minimally invasive. A diagnostic laparoscopy and consequently resection of the necrotic fundus was performed. A postoperative symptomatic left pleural effusion resolved after chest tube insertion. One week later, the patient was discharged with satisfactory results.

Adult↗
PubMed2004

On appropriate pathology for photothermal surgery.

BACKGROUND AND OBJECTIVES: The standard hematoxylin and eosin (H&E) stain can yield dramatic underestimates of tissue death when pathology is performed immediately after radiative surgery. Our objectives were to identify an accurate, consistent histology, and to understand under what conditions the problem is manifested. STUDY DESIGN/MATERIALS AND METHODS: Photothermal surgery with highly concentrated sunlight was performed ex vivo on chicken livers, and in vivo on healthy live rats that were sacrificed at periods of 0, 24, 48, and 72 hours. Pathology with both H&E and an alternative NADH-diaphorase (NADH) stain were prepared. RESULTS: H&E pathology performed shortly after surgery errs by close to an order of magnitude in appraising lesion volume, but the shortfall is mitigated when histological examination is postponed for 24 hours. The biochemical signals missed by the H&E technique at short times can be captured by the NADH stain which reveals the cessation of enzymatic activity, albeit at greater expense and complexity. CONCLUSIONS: The significance lies in avoiding false positives in surgery, providing reliable estimates of photothermal surgical efficacy, and highlighting the relative merits of alternative histological practices with photothermal surgery.

Animals↗
PubMed2003

The experience with a modified technique for laparoscopic ventral hernia repair.

In this article, we describe a modified technique for laparoscopic ventral hernia repair that is easy to perform and teach. The three-keyhole process comprises two major steps: laparoscopic appreciation of the outlet dimension of the hernia and pin-tucking an appropriately sized polytetrafluoroethylene patch after the smooth face has been oriented toward the viscera. We report our experience of 231 patients who underwent the procedure electively between January 1997 and December 2001 with satisfactory results. We suggest that this method be used for all hernia defect-sized elective incisional hernias.

Device Removal↗
PubMed2003

The potential for organ donation in a university hospital in Israel.

BACKGROUND: One of the major reasons for the shortage of organs for transplantation in Israel is the failure to identify potential donors. According to the World Health Organization, the expected number of potential donors in Israel is 300 per year. In recent years an average of only 200 donors (2/3) has been identified. OBJECTIVE: To identify the reasons for the gap between the potential and the actual number of organ donors. METHODS: We reviewed the medical records of all potential donors at the Soroka University Medical Center between October 1997 through September 1999. RESULTS: The total of 183 death records was consistent with the minimal inclusion criteria for potential organ donation, of which 41 were suspected to be potential brain death. In 31 cases an ad hoc committee had declared brain death, and the patients were evaluated for organ donation. However, in 10 cases no committee was formed. We found that 24.4% (10/41) of the potential donors had not been designated as such by their medical team. CONCLUSION: We believe that a comprehensive education program for medical and nursing staff might increase awareness for organ donation and may eliminate the gap between the potential and actual number of organ donors.

Adult↗
PubMed2002

Phase II study of gemcitabine combined with radiation therapy in patients with localized, unresectable pancreatic cancer.

BACKGROUND AND OBJECTIVES: Gemcitabine is an active agent in pancreatic cancer, with known radiosensitizing properties. Therefore, a phase II study was conducted to evaluate the efficacy of gemcitabine combined with radiation therapy in patients with localized unresectable adenocarcinoma of the pancreas. METHODS: Weekly gemcitabine at a dose of 1,000 mg/m(2) for 7 weeks was given as an induction phase. Patients who showed both clinical benefit response (CBR) and reduced or stable tumor size on computed tomography (CT) scan entered the chemoradiotherapy phase of the treatment. This consisted of gemcitabine 400 mg/m(2) weekly x3 every 28 days for 2 cycles, given concurrently with radiotherapy, for a total dose of 50.4 Gy in 28 fractions. After completion of radiotherapy, gemcitabine was continued as maintenance. RESULTS: Twenty patients entered this study. Ten patients (50%) achieved CBR to gemcitabine in the induction phase; these patients had no objective tumor progression and were therefore enrolled in the chemoradiotherapy phase. Four patients (20%) had a partial response, and three patients (15%) underwent pancreatectomy. Two patients had negative surgical margins, and in one patient histologic examination of the residual mass showed only fibrosis. The median survival for the entire group was 8 months, and the median survival has not yet been reached for the chemoradiotherapy group. CONCLUSIONS: Treatment with gemcitabine concomitant with radiation therapy according to the present schedule is well tolerated and can provide prolonged CBR and disease stabilization in patients with localized, unresectable pancreatic cancer.

Adenocarcinoma↗
PubMedDate not supplied

Vascular endothelial growth factor-releasing scaffolds enhance vascularization and engraftment of hepatocytes transplanted on liver lobes.

Hepatocyte transplantation within porous scaffolds (HT) is being explored as a treatment strategy for end-stage liver diseases and enzyme deficiencies. One of the main issues in this approach is the limited viability of transplanted cells because vascularization of the scaffold site is either too slow or insufficient. We now address this by enhancing scaffold vascularization before cell transplantation via sustained delivery of vascular endothelial growth factor (VEGF), and by examining the liver lobes as a platform for transplanting donor hepatocytes in close proximity to the host liver. The vascularization kinetics of unseeded VEGF-releasing scaffolds on rat liver lobes were evaluated by analyzing the microvascular density and tissue ingrowth in implants harvested on days 3, 7, and 14 postimplantation. Capillary density was greater at all times in VEGF-releasing scaffolds than in the control scaffold without VEGF supplementation; on day 14, it was 220 +/- 33 versus 139 +/- 23 capillaries/mm2 (p < 0.05). Furthermore, 35% of the newly formed capillaries in VEGF-releasing scaffolds were larger than 16 microm in diameter, whereas in control scaffolds only 10% exceeded this size. VEGF had no effect on tissue ingrowth into the scaffolds. HT onto the implanted VEGF-releasing or control scaffolds was performed after 1 week of prevascularization on the liver lobe in Lewis rats. Fifty implants were harvested on days 1, 3, 7, and 12 and the area of viable hepatocytes was evaluated. The enhanced vascularization improved hepatocyte engraftment; 12 days after HT, the intact hepatocyte area (136,910 microm2/cross-section) in VEGF-releasing scaffolds was 4.6 higher than in the control group. This study shows that sustained local delivery of VEGF induced vascularization of porous scaffolds implanted on liver lobes and improved hepatocyte engraftment.

Alginates↗
PubMedDate not supplied

Photothermally induced delayed tissue death.

We report pronounced delayed tissue death in photothermal surgery performed on the livers of live healthy rats with highly concentrated sunlight (ultrabright noncoherent light). Exposure times and power levels were selected to produce immediate necroses of the order of hundreds of cubic millimeters. Pathology reveals that lesion volumes increase by up to a factor of 5 within approximately 24 h after surgery, and then stabilize. Islands of viable cells can persist within damaged tissue, in the immediate vicinity of blood vessels, but also necrose within about 48 h.

Animals↗
PubMedDate not supplied

Fiberoptic surgery by ultrabright lamp light.

We report the first realization of interstitial surgery by ultrabright lamp light, on the kidneys and livers of live animals. A high-flux optic concentrates lamp emissions into an optical fiber for power delivery inside the body. The trials reveal surgical efficacy comparable to corresponding laser fiber optic treatments, as well as pronounced delayed tissue death.

Animals↗