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Biomedical subjects

Z B Niazi

Publications and source records attributed to Z B Niazi.

At least 19 recordsLinked to original sources
PubMed2001

Vaginal reconstruction with a rectus abdominis musculoperitoneal flap.

In more than 300 clinical cases, the authors have observed and documented the presence of a branch of the deep inferior epigastric artery that penetrates the posterior rectus sheath near the umbilicus. Their cadaveric anatomic and animal injection studies confirm the vascularity of the peritoneum via the deep inferior epigastric artery. They report 2 patients treated with a new technique of vaginal reconstruction using a thin, pliable flap with a peritoneal-lined rectus abdominis muscle based on the deep inferior epigastric vessels.

Adolescent↗
PubMed1998

Vascularized muscle flaps and reoperative approach for complicated, dehisced sternal wounds in children.

Vascularized muscle flaps for treatment of mediastinitis and sternal wound dehiscence have become standard treatment practice, but triple-muscle flap reconstruction is reserved for the more complex wounds. The incisional approach for reoperation in such patients is controversial. We report an extremely ill infant, born at 38 weeks gestational age, who underwent an arterial switch procedure for transposition of the great arteries at 12 days of age. Sternal wound infection, dehiscence, mediastinitis, and extensive wound necrosis complicated the postoperative course. The cultured organism Enterobacter is a relatively rare cause for median sternotomy wound infection and was associated with massive postoperative hemorrhage. The infant underwent multiple debridements and at 2 months of age had reconstructive surgery with bilateral pectoralis major muscle advancement flaps combined with a rectus abdominis muscle flap. Three months postreconstruction the infant required reoperation to correct a stenosis at the site of the pulmonary artery anastomosis. This surgery was carried out through the previous median sternotomy scar because it was the safest, most direct approach and would also limit additional scarring. Long-term follow-up at 2 years of age shows a well-developed young boy with no limitations in growth and activity.

Anti-Bacterial Agents↗
PubMed1997

Operative repair of pressure ulcers.

Surgical management of pressure ulcers ranges from débridement and advancement flap closure for simple ulcers to sensate flaps, expanded flaps, free-tissue transfers, and fillet flaps for more complex ulcers and defects. Some pressure ulcers recur following surgery or conservative treatment, and the surgical options for management of these difficult recurrent ulcers are limited. The geriatric population offers an even more difficult problem as patients suffer invariably from underlying medical and systemic diseases that may affect surgery or the rehabilitation program.

Age Factors↗
PubMed1997

Surgical management of pressure ulcers.

Surgical management of pressure ulcers ranges from office or bedside debridement to formal debridement in the operating room for the more extensive necrosis. Closure of these wounds may be by advancement flap closure for the simple ulcers and by local muscle or myocutaneous flap closure for the more complex ulcers and defects. Some pressure ulcers recur following previous surgery or following conservative treatment. The simple recurrences can be managed by the use of simple techniques while the surgical options for the management of the more difficult recurrent ulcers are limited involving more complex surgery like sensate flaps, expanded flaps, free tissue transfers and fillet flaps.

Humans↗
PubMed1996

Orthotopic vascularized osteochondral allografts in an immunosuppressed rat model.

This study examined the survival of orthotopic, vascularized, osteochondral allografts, following 12 weeks of immunosuppression and transfer into a naive, allograft host up to 14 weeks later, and compared the results with those previously reported for similar grafts in a heterotopic position. Knee-joint allografts between DA (donor) and Lewis (recipient) rat strains were assessed by quantitative histology up to 6 months after transplantation, and graft microcirculation was examined by India-ink infusion. Graft repopulation was assessed by re-transferring the graft to a naive, non-suppressed allograft host 12 to 26 weeks after the initial transplantation. Isografts survived for as long as grafts were examined (6 months) and showed good healing of the graft/host bone junction, although long-term isografts showed some deterioration of the growth plate. Non-suppressed allografts rejected within 2 weeks. Allografts in hosts immunosuppressed for 12 weeks remained healthy and healed in a similar manner to the isografts. Following cessation of immunosuppression, allografts progressively deteriorated, with mononuclear cell infiltration apparent in graft bone marrow and muscle in the later stages examined. Transfer to second non-suppressed hosts resulted in rapid rejection of the allografts, indicating that, as shown previously in heterotopic, osteochondral allografts, little or no graft repopulation by host-derived cells had occurred during the protected period in the first host.

Animals↗
PubMed1996

Candida albicans infection of bilateral polyurethane-coated silicone gel breast implants.

We present a report of bilateral Candida albicans infection of polyurethane-coated silicone gel prostheses and an acute onset of unilateral capsular contracture 4 years after breast augmentation. The patient was treated by removal of implants, antibiotic irrigation of the capsule cavities, and immediate replacement with new implants. Following histopathologic diagnosis, the patient was treated with a course of fluconazole and remains symptom free at the 12-month follow-up.

Adult↗
PubMed1996

Immediate skin expansion: an old concept by a novel and inexpensive technique.

Intraoperative skin expansion is not a new concept. We have developed a technique using readily available inexpensive material to achieve wound closure. In this prospective study, 15 patients (age range, 1-72 years) with melanoma, giant nevi, scars, meningocele, gastroschisis, alopecia, thrombosed renal dialysis fistula, calcified nodule and trauma, with defects on back, limbs, abdomen, scalp, hand, calcaneum, and sole of foot were treated. Only hypodermic needles and dental wire, with an overall cost of less than a dollar, are needed for the immediate skin expansion technique. In contrast, the numerous other commercial devices currently in use are costly and must be ordered in advance. Using our technique, the wound can be gradually approximated and subcutaneous sutures placed with the device in situ. An intradermal or simple running suture is then placed to approximate the skin edges under little or no tension and the device is removed. All patients had a good result with minimal morbidity. The wounds treated by this technique healed by primary intention except in 3 patients, who developed minor dehiscence of the wounds.

Adolescent↗
PubMed1995

New technique of levator lengthening for the retracted upper eyelid.

Retraction of the upper eyelid associated with shortening of the levator mechanism occurs most commonly in association with Graves' disease but occasionally arises as a complication of blepharoplasty or other surgical procedures. A new technique of a castellated type aponeurotomy of the levator aponeurosis is carried out to lengthen the levator. This procedure appears to give a predictable, stable and symmetrical result.

Aged↗
PubMed1994

Nitric oxide synthase inhibitor, nitro-iminoethyl-L-ornithine, reduces ischemia-reperfusion injury in rabbit skeletal muscle.

Nitric oxide (NO), originally identified as the mediator of endothelial-dependent relaxation of vascular smooth muscle, is now known to also have cytotoxic effects under certain conditions. Thus, we have investigated the effects of inhibition of NO synthesis on ischemia/reperfusion injury in the rabbit rectus femoris muscle. Three and a half hours of ischemia and 24 hours of reperfusion resulted in a 56% loss of viability. In muscles receiving an infusion of the nitric oxide synthase inhibitor, L-NIO (30 microM), the loss of viability was reduced to 15%. Post-ischemic blood flow was increased in muscles receiving a saline infusion, whereas there was a marked decrease in blood flow for at least the first 60 minutes of reperfusion in muscles treated with L-NIO (30 microM). The increase in myeloperoxidase levels (indicative of neutrophil accumulation) following 24 hours of reperfusion was attenuated with L-NIO infusion by approximately 50% and the reperfusion-induced edema was also attenuated in L-NIO treated muscle. These findings suggest that endogenous NO production during ischemia/reperfusion injury may be deleterious to muscle survival.

Amino Acid Oxidoreductases↗
PubMed1994

The radial forearm flap: a reconstructive chameleon.

The authors present a ten-year series of consecutive one-stage reconstructions of defects following excision of malignant disease and of traumatic defects, using the radial forearm flap. Of the 155 radial forearm flaps performed, 144 were free flaps and 11 were pedicled flaps; 55 of the 144 free flaps were osteofasciocutaneous. Microvascular reconstructions with this versatile flap had a 98 percent success rate in this series.

Extremities↗
PubMed1993

Perineural infiltration in basal cell carcinomas.

4376 basal and squamous cell carcinomas were dealt with over a period of 100 months. 76.6% of these were basal cell carcinomas. Perineural spread was noted in 0.178% of basal cell lesions and in all examples was found in recurrent tumours, which were predominantly in the preauricular and malar areas in this series.

Aged↗