Biomedical subjects

W Omar

Publications and source records attributed to W Omar.

4 recordsLinked to original sources

PubMed2003

Augmented unilateral gluteoplasty with fascia lata graft in fecal incontinence.

BACKGROUND: This study was undertaken to evaluate the results of augmented unilateral gluteoplasty with fascia lata graft in patients with fecal incontinence due to congenital or neurologic disorders. METHODS: Between January 2000 and January 2001, we performed a prospective study of 11 patients with longstanding fecal incontinence (stage C3 according to Pescatori scoring system for fecal incontinence). The patients included one girl and 10 boys aged 5-19 years who had already undergone Swenson's operation for congenital megacolon (7 patients) or abdominoperineal pull-through for high imperforate anus (4 patients). Preoperative anorectal manometric studies (maximum resting pressure, maximum squeeze pressure, rectoanal inhibitory reflex and functional anal canal length), saline enema test and magnetic resonance imaging (MRI) studies were done. Unilateral gluteoplasty augmented with fascia lata graft was wrapped around the anal canal. Biofeedback retraining was started at the beginning of the fourth postoperative week. Patients were followed both objectively and subjectively for about 6-18 months. RESULTS: Eight of 11 patients (72.7%) were clinically improved, as shown by the change in incontinence score ( p=0.01). this was confirmed by the significant changes in manometric studies, functional anal canal length, rectoanal inhibitory reflex and saline enema test. MRI done one month postoperatively showed disruption in one patient. CONCLUSIONS: Unilateral gluteoplasty augmented with fascia lata graft leads to encouraging results in patients with end-stage anal incontinence due to irreversible damage to anal sphincter with less incidence of morbidity that could be related to tension on either the muscle flap or its neurovascular bundle.

Adolescent↗

PubMed2003

99mTc-MIBI in the assessment of response to chemotherapy and detection of recurrences in bone and soft tissue tumours of the extremities.

AIM: This prospective study is focused on the assessment of tumour response in a group of 28 bone sarcoma patients using (99m)Tc-MIBI scintigraphy. METHODS: The quantitative changes in MIBI uptake before and after chemotherapy were measured and associated with the pathological evaluation of the degree of tumour necrosis. Besides this, another group of 40 patients with bone and soft tissue tumours was studied in order to evaluate the diagnostic efficacy of (99m)Tc-MIBI scintigraphy versus computed tomography (CT) and/or magnetic resonance imaging (MRI) in detecting the status of the disease and its recurrences. After injection of 555-740 MBq of (99m)Tc-MIBI, regional and whole body images were acquired at 20 and 60 min. The lesion/normal (L/N) uptake ratio was calculated in both early and delayed images and the washout rate (WR%) of (99m)Tc-MIBI was obtained. Following 3-4 courses of chemotherapy, bone tumours were assessed by comparing the uptake ratio in the viable tumours with the amount of necrotic processes described in the surgically removed specimens. RESULTS: In the first group of patients the rate of tumour response to chemotherapy, calculated according to the percentage of necrosis and the (99m)Tc-MIBI uptake ratios, was as follows: complete response in 12 patients, partial response in 8 and no response in 8 patients. Linear regression analysis of quantitative changes in (99m)Tc-MIBI uptake (expressed as changes percent) and of (99m)Tc-MIBI uptake ratio showed a positive correlation (r=0.77), whereas it showed a negative correlation with the changes in the washout ratio (r=-0.32). In the second group of patients (40 patients) (99m)Tc-MIBI scintigraphy proved to be able to detect recurrences of bone and soft tissue tumours. The sensitivity, specificity and accuracy of (99m)Tc-MIBI scan versus CT and/or MRI were calculated and they resulted 93%, 95% and 92% versus 86%, 75% and 84%, respectively. CONCLUSION: The application of (99m)Tc-MIBI scan in the management of patients treated with chemotherapy may allow an early identification of the non-responder patients and lead to a choice of different strategies (alternative chemotherapy or salvage surgery).

Adolescent↗

PubMed2000

Breast carcinoma.

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Journal Article↗

PubMed2000

SPECT brain perfusion findings in mild or moderate traumatic brain injury.

BACKGROUND: The purpose of this manuscript is to present the findings in the largest series of SPECT brain perfusion imaging reported to date for mild or moderate traumatic brain injury. PATIENTS AND METHODS: This is a retrospective evaluation of 228 SPECT brain perfusion-imaging studies of patients who suffered mild or moderate traumatic brain injury with or without loss of consciousness (LOC). All patients had no past medical history of previous brain trauma, neurological, or psychiatric diseases, HIV, alcohol or drug abuse. The patient population included 135 males and 93 females. The ages ranged from 11-88 years (mean 40.8). The most common complaints were characteristic of the postconcussion syndrome: headaches 139/228 (61%); dizziness 61/228 (27%); and memory problems 63/228 (28%). LOC status was reported to be positive in 121/228 (53%), negative in 41/228 (18%), and unknown for 63/228 (28%). RESULTS: Normal studies accounted for 52/228 (23%). For abnormal studies (176/228 or 77%) the findings were as follows: basal ganglia hypoperfusion 338 lesions (55.2%); frontal lobe hypoperfusion 146 (23.8%); temporal lobes hypoperfusion 80 (13%); parietal lobes hypoperfusion 20 (3.7%); insular and or occipital lobes hypoperfusion 28 (4.6%). Patients' symptoms correlated with the SPECT brain perfusion findings. The SPECT BPI studies in 122/228 (54%) were done early within 3 months of the date of the accident, and for the remainder, 106/228 (46%) over 3 months and less than 3 years from the date of the injury. In early imaging, 382 lesions were detected; in 92 patients (average 4.2 lesions per study) imaging after 3 months detected 230 lesions: in 84 patients (average 2.7 lesions per study). CONCLUSIONS: Basal ganglia hypoperfusion is the most common abnormality following mild or moderate traumatic brain injury (p = 0.006), and is more common in patients complaining of memory problem (p = 0.0005) and dizziness (p = 0.003). Early imaging can detect more lesions than delayed imaging (p = 0.0011). SPECT brain perfusion abnormalities can occur in the absence of LOC.

Journal Article↗