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Biomedical subjects

T Salman

Publications and source records attributed to T Salman.

At least 19 recordsLinked to original sources

Neutropenic enteropathy.

Neutropenic enteropathy (NE) is used to describe the inflammation of the bowel in neutropenic patients under aggressive chemotherapy, mainly for lymphoproliferative and hematologic malignancies. Surgical intervention may be required in patients with the advent of the disease. We report our experience in 7 children with NE who had to be treated surgically. Absolute neutrophil counts were less than 1000/mm3 in all, with positive blood cultures in five patients. Four patients recovered with rapid resolution of neutropenia, while three patients died with persistent neutropenia.

Adolescent↗

Abdominal tuberculosis in children.

UNLABELLED: Abdominal tuberculosis (AT) is a rare cause of intraabdominal infection. Surgical intervention is rarely indicated, other than obtaining a specimen for histopathological diagnosis or for the treatment of complications. METHODS: The medical records of 14 patients who were operated on after the diagnosis of AT between 1983 and 2000 were reviewed retrospectively. RESULTS: Median age was 7 years (6 months to 10 years). The presenting clinical signs and symptoms were as follows: colicky abdominal pain (9), weight loss (8), abdominal mass (6), vomiting (5), and night fever (5). Two patients were operated at another centre and referred to our department with faecal fistula and severe malnutrition. Twelve patients were operated on, while diagnostic laparoscopy was performed in two. In uncomplicated cases, surgical intervention was limited to sampling of peritoneal tissue, lymph node and ascites. The reasons for surgical intervention were intestinal obstruction (9), abdominal mass and ascites (6), psoas abscess (1) and intussusception (1). Adhesive peritonitis and ileal loops were the cause of abdominal mass. Necrosis of the bowel (2) and perforation (1) were detected in three patients. The diagnosis was confirmed either by histopathological or microbiological examination. In eight patients, AT was defined at the intestinal mesentery, in three patients it was localised to the peritoneum and in two patients the disease was diffuse. All patients except one with faecal fistula survived and were treated successfully with antituberculous therapy (isoniasid, rifampicin, streptomycin and pyrazinamide combination). CONCLUSION: The diagnosis of AT is difficult before presentation with complications of intraabdominal infection. Since the response to chemotherapy is usually excellent in patients with suspected AT, aggressive surgery should be avoided and initial surgical intervention should be limited to tissue and/or fluid sampling.

Child↗

Primary torsion of the omentum in a 6-year-old boy: report of a case.

In the absence of any pathological condition in the pelvis of children who present with acute abdomen, the observation of serosanguineous intraabdominal fluid should prompt the surgeon to investigate the omentum. A 6-year-old boy who was admitted with a clinical picture of acute appendicitis, and was later diagnosed during a laparotomy to have primary torsion of the omentum, is reported. Obesity, exercise, and the presence of a bifid omentum were confirmed to be the predisposing factors.

Child↗

Congenital granular-cell tumor of the gingiva.

Congenital granular cell tumors of the gingiva (synonyms: congenital myoblastoma, congenital epulis) originate from the alveolar ridge in newborns. They are rare granular-cell tumors with benign histology. The main differential diagnosis is epignathus (oral teratoma). Early surgical excision is recommended due to a risk of airway obstruction and difficulty feeding.

Gingival Neoplasms↗

Fetal intestinal transplant as an accessory enteral segment.

Fetal tissue transplantation has gathered considerable interest among researchers dealing with organ transplantation. A large number of studies concerning fetal intestinal transplantation have been published in the past 2 decades, almost all of them aiming to determine the feasibility of a properly functioning fetal transplant in continuity with the host's own enteral system. This study was designed to determine the absorptive capacity of the neogut in vivo, without anastomosing the transplant to the host's intestine, and to evaluate its use as an accessory enteral segment. Intestinal segments taken from Wistar albino fetuses were transplanted subcutaneously into the abdominal wall of 20 Sprague-Dawley rats. Immunosuppression was maintained by daily cyclosporin A (Cy A) 10 mg/kg injections s.c. and evaluated by determination of serum Cy A level and T-helper/T-suppressor cell ratio. The neogut was converted into a Thiry-Vella loop 2 weeks after transplantation. A test solution composed of 20% glucose and Trophamine was perfused via the stomas; glucose and amino acid absorption gradients were calculated. The gamma-glutamyl transferase (GGT) activity and mitotic index of the neogut were determined. Results were compared to those obtained from the host. There was no significant difference (P > 0.05) in glucose absorption between the neogut and the host tissue. Amino acid absorption and specific GGT activity were significantly less (P < 0.01) in the neogut. There was no significant difference (P > 0.05) between neogut and host intestine in mitotic index. Our data support the idea of using a transplanted fetal intestinal segment as an accessory feeding route.

Amino Acids↗

In vivo genotoxicity of dichloroacetic acid: evaluation with the mouse peripheral blood micronucleus assay and the single cell gel assay.

Chlorination is a widely used method for disinfection of drinking water supplies. Reaction of chlorine with naturally present organic compounds can result in toxic by-products. One major disinfection by-product from the chlorination of drinking water is dichloroacetic acid (DCA). This chemical has been shown to be carcinogenic in rodents, yet little genotoxicity data are available to assess the possible role of DNA and/or chromosomal damage in this process. We have used the peripheral blood erythrocyte micronucleus (MN) assay and the alkaline single cell gel electrophoresis (SCG) technique to investigate the in vivo genotoxicity of DCA in bone marrow and blood leukocytes, respectively. The MN assay detects chromosome breakage and/or malsegregation, while the SCG assay detects DNA damage (e.g., single strand breaks, alkali-labile sites, crosslinking). Mice were exposed to this compound in drinking water, available ad libitum, for up to 31 weeks. Our results show a small but statistically significant dose-related increase in the frequency of micronucleated polychromatic erythrocytes (PCEs) after subchronic exposure to DCA for 9 days. In addition, at the highest dose of DCA tested (3.5 g/l), a small but significant increase in the frequency of micronucleated normochromatic erythrocytes (NCE) was detected following exposure for > or = 10 weeks. Coadministration of the antioxidant vitamin E did not affect the ability of DCA to induce this damage, indicating that the small induction of MN by DCA was probably not due to oxidative damage. Based on the lack of any difference observed in the proportion of kinetochore-positive micronuclei between the treated and control animals, we interpret MN as arising from clastogenic events. The SCG technique suggested the presence of DNA crosslinking in blood leukocytes in mice exposed to 3.5 g/l DCA for 28 days. These data provide evidence that DCA may be an extremely weak inducer of chromosome damage when provided to mice in drinking water under conditions which lead to increased levels of tumors.

Animals↗

Urinary gonadotropin peptide (UGP) in Egyptian patients with benign and advanced malignant urological disease.

Urinary gonadotropin peptide (UGP) levels were determined in urine samples from 450 Egyptian subjects to determine its relative level of expression in benign and malignant urological disease, and normal individuals. The mean UGP level in patients with bladder cancer was 44-fold higher than in patients with benign disease, and 81-fold higher than in normal individuals. At specificities of 95% and 100%, overall sensitivities of 73% and 60%, respectively, were observed for the detection of malignant disease. Mean UGP levels in patients with bladder cancer were significantly correlated with the stage and grade of malignant disease but did not vary significantly when stratified according to histological type of disease, nodal involvement or bilharzial association. UGP could be a potentially useful marker for the differentiation of benign from malignant urological disease.

Adult↗

Wilms' tumor and associated malformations; report of two cases with WAGR and Drash syndrome.

The combination of Wilms' tumor with aniridia, ambiguous genitalia/gonadoblastoma and mental retardation is defined as WAGR syndrome. The association with pseudohermaphroditism and nephropathy was also described as Drash syndrome. Here we report two cases with WAGR and Drash syndrome. The importance of early recognition and appropriate management of Wilms' tumor with those concurrent malformations is highlighted.

Child, Preschool↗

Cathepsin-D and TNF-alpha in bladder cancer.

In a study of 34 normal healthy controls, 35 patients with urinary tract bilharziasis and 93 bladder cancer patients (62 of them are operable cases and 31 are non-operable ones), serum tumor necrosis factor alpha (TNF-alpha) and cytosolic Cathepsin-D were estimated. Though both potential markers were elevated in bladder cancer patients, neither Cathepsin-D nor TNF-alpha showed associations of prognostic value since there were no positive correlations with tumor stages, grades or association of tumors with bilharzial ova or lymph node involvement.

Adolescent↗

Traumatic coronary sinocameral fistula from a penetrating cardiac injury: case report and review of the literature.

Clinically apparent penetrating cardiac wounds require emergent surgical therapy without the theoretical benefit of preoperative evaluation apart from the physical examination. Residual intracardiac injuries discovered following the successful resuscitation and repair of immediate life-threatening cardiac wounds should be sought in survivors of chest trauma who demonstrate new regurgitant murmurs or evidence of congestive heart failure. To our knowledge, we report here the second case of a traumatic left ventricle-to-coronary sinus fistula, along with recommendations for its management.

Adult↗

Repair of pectus deformities with sternal support.

During the past 25 years, 252 children underwent repair of pectus deformities. There were 195 male and 57 female patients, of whom 227 had pectus excavatum and 25 had pectus carinatum. Of the 252 patients, 113 underwent repair at between 2 and 5 years of age. Exercise limitation was reported by 51%, and 32% had frequent respiratory infections or asthma. Repair was performed through a transverse incision with subperiosteal resection of the lower four or five costal cartilages, from sternum to costochondral junction bilaterally. A transverse wedge osteotomy was made through the anterior table of the sternum, with fracture but no displacement of the posterior table. For children younger than 5 years (n = 108), the periosteal sheath of the fifth rib from each side was sewn together behind the sternal tip. For older patients (n = 136), a thin steel strut was used for sternal support for 6 months. There were no deaths within the first year. Complications included seroma (16), atelectasis (12), pneumothorax (three), and recurrent chest depression (three). More than 98% of patients had improvements in exercise tolerance, endurance, respiratory symptoms, and cosmetic appearance; these improvements were considered excellent results. Operation at an early age with routine use of substernal support with minimal preoperative and postoperative testing has provided excellent results at a low cost.

Adolescent↗

The clinical value of serum TPS in gynecological malignancies.

This study included 75 cases; 39 with gynecological cancer of different types, stages, and grades (14 ovarian, 11 endometrial, 9 cervical, and 5 vulvovaginal); 23 patients with benign gynecological diseases and 13 normal healthy controls. Serum TPS was estimated using the ELISA kit supplied by Beki Diagnostic AB, Bromma, Sweden. The results of the present study revealed that serum TPS was significantly elevated in cancer patients followed by those with benign diseases. When the cutoff values were adjusted to 137 and 101 U/L, we obtained sensitivities of 56.4% and 82.1% at specifities of 100% and 85%, respectively. The benign diseases group had false positive rates of 13% and 34.8%, respectively. When considering tumor site, vulvo vaginal cancer showed the highest sensitivity (80%) followed by cervical (66.7%), ovarian (50%), and lastly endometrial cancer (45.5%). Serial measurement of TPS was shown to be of important value in the post-surgical follow-up of cancer patients.

Adolescent↗

Clinical value of squamous cell carcinoma antigen (SCC-A) in Egyptian gynecologic cancer patients.

Squamous cell carcinoma (SCC) antigen levels were measured by immunoparticle assay (IMx) in the sera of 32 patients with gynecologic malignancies, 15 with benign diseases of the genital system and 14 normal healthy controls. At a cut-off value of 4.8 ng/ml (100% specificity), the rate of SCC antigen elevation was 100% in vulvar and vaginal cancer (n = 5), 90% in ovarian cancer (n = 10), 60.0% in endometrial cancer (n = 10) and 57.2% in cervical cancer (n = 7). The benign disease's group had 80.0% false positivity at the same cut-off value. Serum SCC-A was found to correlate directly with the clinical stage of disease. A sensitivity of 73.3% was obtained at stage I which gives SCC-A a role in screening the high risk population for gynecological cancer. Concerning the histopathologic type of tumor, serum SCCA was highly sensitive in SCC tumors, in ovarian serous cystadenocarcinoma and in patients with recurrent ovarian cancer.

Adolescent↗