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Biomedical subjects

A Behbehani

Publications and source records attributed to A Behbehani.

At least 19 recordsLinked to original sources

Serum changes in trace elements during thyroid cancers.

The objective was to examine changes in trace elements due to thyroid cancer in humans. Serum levels and tissue contents of trace elements (Zn, Cu, Mn, Mg, Fe and Se) were measured in 43 patients with thyroid cancer before and 4 days after surgery were compared to normal values. The serum levels of zinc in cancer patients were lower than those of normal subjects. Surgical removal of the cancer resulted in the restoration of these levels. Although serum Cu levels in patients were not different from normal, but post-operatively these levels rose significantly (p < 0.001). Levels of Fe, Mg and Mn were significantly lower (p < 0.001) post-operatively. There was no significant change in Serum Se levels. The thyroid tissue contents of these trace elements did not show a difference between the normal (Juxta-tumor) thyroid tissue and the cancerous lesion. Out of the six trace elements examined, the decrease of serum levels of zinc in cancer patients may be linked to the disease condition. It is suggested that this change: (a) may be used to demonstrate successful cancer surgery and (b) may have implications for a long-term follow-up of thyroid cancer patients.

Adenocarcinoma, Follicular↗

Serum antioxidant and cholesterol levels in patients with different types of cancer.

Serum antioxidant (urate, alpha-tocopherol) activity and cholesterol concentration in 142 patients of Indian and Arab (Kuwaitis and other Arabs) origin with different types of cancer (breast, colon, stomach, thyroid, oral, rectal, pancreatic, and renal) were compared to 100 age- and sex-matched control subjects. Values were expressed as medians (interquartile range). Urate concentration was significantly decreased in male patients compared to male controls (P < 0.0001) and in female patients and female breast cancer cases compared to female controls; P < 0.0001 and P = 0.001, respectively. Alpha-tocopherol concentration decreased significantly in total cancer, stomach, colon, rectal, and breast cancer cases than the controls; P < 0.0001, P < 0.0001, P < 0.0001, P = 0.012, and P = 0.022, respectively. Cholesterol concentration decreased significantly in stomach, oral, colon, and total cancer cases compared to the controls; P < 0.0001, P < 0.0001, P = 0.002, and P = 0.012, respectively. Among controls, females had significantly (P < 0.0001) lower concentrations of alpha-tocopherol than males. Among patients, cholesterol, urate, and alpha-tocopherol concentrations decreased significantly in smokers than in nonsmokers; P < 0.0001, P = 0.004, and P = 0.047, respectively. Generally, changes in alpha-tocopherol/cholesterol ratios mimicked changes in alpha-tocopherol concentration. Concentrations of all parameters decreased significantly in male patients compared to male controls. Age was positively associated with all three analytes with respect to the controls. Alpha-tocopherol correlated with cholesterol in cancer patients (r = 0.367; P < 0.0001) and with urate in the controls (r = 0.342; P < 0.0001). The data suggest cancer-related diminished synthesis of cholesterol and, generally, a greater antioxidant burden for alpha-tocopherol than urate in cancer-generated oxidative stress. The increased incidence of pancreatic cancer in Kuwaitis warrants further study.

Adult↗

Plasma concentrations of alpha-tocopherol and urate in patients with different types of cancer.

OBJECTIVE: To measure plasma concentrations of alpha-tocopherol and urate to determine whether there is any relationship with different types of cancer before treatment. METHOD: Plasma concentrations of those two antioxidants were measured in cancer patients and sex- and age-matched controls. Plasma total cholesterol concentration was measured to derive an alpha-tocopherol/cholesterol ratio. RESULTS: Alpha-tocopherol and urate concentrations as well as alpha-tocopherol/cholesterol ratios were significantly lower in the cancer patients as whole, in gastrointestinal cancer and in breast cancer compared to the controls. There was no significant relationship between alpha-tocopherol and urate levels in either the plasma of patients (r=0.048; P=0.653) or controls (r=0.073; P=0.406). Alpha-tocopherol was more positively correlated with cholesterol in the plasma of controls (r=0.539; P < 0.0001) in comparison with the patients (r=0.456; P < 0.0001). There was no significant correlation between urate and cholesterol levels in both patient and control plasma samples. CONCLUSION: The data suggest that although alpha-tocopherol and urate provide important antioxidant defence in cancer, the association between their levels is weak.

Adult↗

Plasma micronutrient antioxidant in cancer patients.

The distribution of breast, colon, gastric, thyroid, oral, rectal, pancreatic and renal cancers were determined in 71 Kuwaitis, 45 other Arabs, and 26 Indians. Plasma levels of micronutrient antioxidants, retinol, alpha-tocopherol, lycopene, and beta-carotene were measured in the groups and in 90 matched controls for comparison. Cholesterol was measured to determine its association with the micronutrient antioxidants. Pancreatic cancer occurred exclusively in Kuwaitis, while breast and colon cancers were disproportionately higher in Kuwaitis than in the other groups. Micronutrient antioxidant levels were similar in the groups, except for higher lycopene levels in Kuwaitis. In most instances, the micronutrient antioxidants, except beta-carotene, decreased significantly in levels in patients than in controls. Low levels of retinol, lycopene, and beta-carotene were strongly associated with pancreatic cancer. Compared to controls, significantly increased levels of beta-carotene occurred in breast, colon, thyroid, and renal cancers; increased lycopene occurred in oral cancer, and increased alpha-tocopherol occurred in pancreatic cancer. Alpha-tocopherol strongly correlated with cholesterol. Generally, changes in alpha-tocopherol/ cholesterol ratios mimicked those of alpha-tocopherol levels. Micronutrient antioxidant levels were significantly lower in male patients than female patients. Age showed a negative but statistically insignificant relationship with micronutrient antioxidants. Lycopene strongly correlated with alpha-carotene and alpha-tocopherol with retinol. Among the patients, all micronutrient antioxidants except retinol decreased significantly in levels in smokers than nonsmokers, suggesting susceptibility to cigarette smoke oxidative stress. We conclude that micronutrient antioxidant depletions and altered associations may imply tumor utilization or antioxidant burden in oxidative stress or both. Furthermore, the incidence of pancreatic, colon and breast cancers among Kuwaitis warrants further study.

Adolescent↗

Laparoscopic closure of perforated duodenal ulcer.

BACKGROUND: Medical treatment of peptic ulcer is highly successful, and the eradication of Helicobacter pylori (H. pylori) reduces ulcer recurrence. However, the incidence of perforated duodenal ulcer and its associated mortality have not been reduced by modern methods of therapy. Laparoscopic simple closure and omental plug by suturing, fibrin glue, and stapler have been successful. METHODS: Over a 1-year period (1996-97), 21 patients with perforated duodenal ulcer were operated on in our hospital by laparoscopic simple closure and omental patch. The mean age was 36.4 +/- 11.8 years (range, 18-61). Twenty patients were male (93.7%). The mean duration of pain was 9.1 +/- 11.7 hs (range, 2-48). Three patients had a previous history of duodenal ulcer (14.3%), and another three (14.3%) patients had a history of nonsteroidal antiinflammatory drug (NSAID) intake. Erect chest radiograph showed that 19 patients had air under the diaphragm (90.5%). Sixteen patients (76.2%) had frank pus in the abdomen, and five patients had a minimal peritoneal reaction (23.8%). RESULTS: The mean operative time was 71.6 +/- 24.6 mins (range, 40-120), and the mean hospital stay was 5.2 +/- 1.6 days (range, 3-9). The mean time to resume oral fluids was 3.1 +/- 0.8 days (range, 2-4). Only one patient was reoperated due to leakage identified by gastrographin swallow. CONCLUSIONS: This procedure is safe and efficient; however, further study of its long-term effectiveness and comparability to existing therapy is still needed.

Adolescent↗

Deep-seated thoracic and abdominal masses: usefulness of ultrasound and computed tomography guidance in fine needle aspiration cytology diagnosis.

Fine needle aspiration cytology (FNAC) was performed under ultrasound and CT guidance in 120 cases. These included abdominal masses (85 cases) and thoracic masses (35 cases) biopsied over a two and a half year period (March 1996 to September 1998). The aim of this study was to assess the contribution of clinico-imaging evaluation and image-guided FNAC to the management of patients with deep-seated mass lesions. Aspirations in the abdomen were performed from various anatomic sites such as liver (56 cases), lymph nodes (18 cases), gastrointestinal tract (three cases), pancreas (six cases), and kidney (two cases). In the thorax, biopsy was performed in the lung (19 cases) and mediastinum (13 cases). In 112 cases (93.4%) FNAC was diagnostic. Of the lesions that were successfully aspirated, 85% were < or = 5 cm in size. No major complication was encountered. All the successful aspirates could be defined as malignant or non-malignant, but tissue differentiation was possible in 63.7% of malignant lesions and 53.8% of benign lesions. Combined clinical and imaging evaluation for malignancy showed 80% sensitivity and 59% specificity. Although clinicoradiological parameters themselves have certain limitations in diagnosing benign versus malignant lesions, in conjunction with guided FNA they are very accurate and safe in diagnosing deep-seated mass lesions in the thorax and in the abdomen. However, the role of FNA in tissue differentiation of solid lesions such as lymphoma requires further study.

Abdominal Neoplasms↗

The anaesthetist and the antiphospholipid syndrome.

Antiphospholipid syndrome is a paradoxical disease state with in vitro prolongation of activated partial thromboplastin time and a strong predilection for in vivo thrombosis. The syndrome can be associated with systemic lupus erythematosus or lupus-like diseases or may be primary, presenting with thrombotic phenomena in young patients with no risk factors for thrombosis. We present two cases seen in two different settings in the hospital.

Adult↗

Role of ultrasonography in blunt abdominal trauma: a prospective study.

OBJECTIVE: To evaluate the role of ultrasonography in screening for blunt abdominal trauma in a general hospital. DESIGN: Prospective study. SETTING: University hospital, Kuwait. SUBJECTS: 53 patients (44 male and nine female) with suspected blunt abdominal trauma or decreased consciousness were studied in the period between March 92 and April 93. INTERVENTIONS: Real time ultrasonography of the abdomen during resuscitation. MAIN OUTCOME MEASURES: The sensitivity and specificity of ultrasonography as an investigative tool and predictor of clinical outcome. RESULTS: Ultrasonography was 85% sensitive, 100% specific, and 96% accurate. The positive predictive value was 100% and the negative predictive value was 95%. The sensitivity was less in the hands of the surgeon than the radiologist (67% compared with 90%). CONCLUSION: Ultrasonography is an accurate, safe method for screening patients with blunt abdominal trauma even in general hospitals.

Abdominal Injuries↗

Abdominal tuberculosis: comparison of sonography and computed tomography.

Sonographic and computed tomography findings were retrospectively compared in 13 patients with proven abdominal tuberculosis who had both diagnostic modalities in their workup. The patients were treated over 9 years in two general hospitals in Kuwait. Ultrasound could detect the same findings as CT in 9 of 13 patients. Both had the same accuracy in detecting the type of ascites (in 6 patients) and solid organ tuberculosis (four lesions). Ultrasound gave useful information but could not completely replace CT as it detected less bowel thickening (3 of 5 lesions) and abdominal tuberculous lymphadenopathy (1 of 4 lesions) than CT scanning.

Abdomen↗

Alterations of trace elements in kidney, spleen and lungs in treated and untreated experimental liver cirrhosis.

Repeated administration of carbon tetrachloride (CC1(4)) to the experimental animals not only produces liver cirrhosis but also pathological changes in different organs. The alteration of trace elements in the plasma and in the liver has been documented. Very limited studies were carried out regarding the alteration of trace elements in different organs in experimental animals subjected to CC1(4) toxicity and the influence of scavengers such as superoxide dismutase (SOD) and allopurinol as preventative measurements. Four groups of animals were studied: CC1(4) and allopurinol (group 1), CC1(4) and SOD (group 2), CC1(4) alone (group 3) and olive oil (group 4). Analysis of tissue concentrations of trace elements in different organ's tissues (e.g. lung, spleen and kidneys) were performed. Histopathological assessments were studied in all groups after 7 weeks of repeated administration of the solutions. Copper contents in the spleen and lungs were significantly high in group 2, while kidney copper contents were significantly high in all experimental groups. Selenium contents in the kidneys and lungs were significantly low in group 1, while it was significantly high in group 2 in all organs. Manganese contents in kidneys was significantly low in group 1 and significantly increased in group 2 in the case of spleen and lung. Lung zinc content was significantly increased in group 2. Spleen zinc decreased significantly only in group 3. Histopathological assessment indicated evidence of interstitial pneumonia in the group treated with allopurinol. The low levels of selenium predisposes to the development of interstitial pneumonia.

Allopurinol↗

Treatment of ischial pressure sores with an inferior gluteus maximus musculocutaneous island flap: an analysis of 31 flaps.

We describe our experience with the use of an island gluteus maximus musculocutaneous flap (from its most inferior part) based on perforators from the inferior gluteal artery. The study is based on a series of 27 patients in whom treatment was carried out for 31 ischial pressure sores. Eight patients had postoperative complications in the form of dehiscence of the donor flap site and/or infection. Follow-up ranged from 6 to 32 months. During this period three patients developed recurrent sores which were treated with other flaps. We feel strongly that the use of this flap should be considered as a first choice in the treatment of the mild to moderate size ischial pressure sore. Its advantages include ease in elevation of the flap and the provision of a vascularized bulky flap which also spares the vascular pedicles of adjacent flaps for future use.

Adolescent↗

War injuries during the Gulf War: experience of a teaching hospital in Kuwait.

The war injuries of 361 patients admitted to Mubarak Al-Kabeer Teaching Hospital, during the Gulf War are reported. More abdominal and chest injuries were seen in this series in comparison with other conflicts owing to the short evacuation time. Of the injuries, 54% were caused by gunshots, 34% were fragment injuries and 5.5% were glass and stab injuries. Civilians accounted for 50% of the injured. Wound infection rate was 7%, average hospital stay was 8.8 days and hospital mortality was 5.5%. We advocate radical wound excision, exploration of penetrating wounds of neck and abdomen, and mainly conservative management of chest injuries that do not involve the mediastinum.

Abdominal Injuries↗

Management of thymoma. A retrospective study.

Thymoma is a relatively rare tumour. Twelve cases seen in Kuwait Cancer Control Centre over a period of 10 years were analyzed. Two patients had Myasthenia gravis at presentation, and one developed it after the treatment, during remission. Six patients had total resection and four had subtotal resection of the tumour; the remaining had only diagnostic biopsy. All the six patients who had total resection were alive, disease-free with three of them Stage III, whereas, of the four cases who had subtotal resection two are dead, one with local disease and the other with pulmonary metastases. Eight patients were given postoperative radiotherapy and none of them relapsed at the primary site. Of the three patients who had chemotherapy, two had partial remission, and the remaining one failed to show any response. Patients with predominantly epithelial type histology fared worse compared to predominantly lymphocytic type and mixed cell type. Histological subtypes, invasiveness of the tumour and completeness of resection and association of Myasthenia gravis as prognostic features are discussed. The role of radiotherapy and chemotherapy as adjunctive treatment to surgery is reviewed.

Adolescent↗

A synopsis of the unconjugated acidic transamination metabolites of phenylalanine in phenylketonuria.

We present blood and urine levels of unconjugated o-hydroxyphenylacetic, phenyllactic and phenylpyruvic acids in 61 children (2 years of age and above) and juveniles with phenylketonuria on or partially off diet. The samples were obtained during 185 scheduled outpatient visits and have been analysed with gas chromatographic methods. The compiled data define reference ranges of phenylalanine transamination capacity and of renal transport of metabolites which may be of value in further studies on the pathogenesis of phenylketonuria.

Adolescent↗

Parotid gland tumours: a 15-year experience.

Between 1973 and 1988, 302 patients underwent surgical operations for parotid gland swelling. Primary operations were performed in 293 cases, while secondary operations for recurrent tumour were performed in nine cases. A total of 244 patients (80.8%) were found histologically to have either a benign parotid tumour or a tumour-like lesion, while 58 patients (19.2%) were diagnosed as having malignant tumours. Two hundred and eighty-nine patients underwent superficial and total conservative parotidectomy and in 13 cases a radical parotidectomy was performed. The median follow-up was 5 years (range 1-15 years). Permanent facial nerve palsy, tumour recurrence, Frey's syndrome and parotid fistula were recorded as 0.7, 0.7, 2.1 and 0.4%, respectively. Thus, with full understanding of the surgical anatomy of the parotid gland and correct tumour identification, preservation of the facial nerve and serious postoperative complications can be minimized following superficial and/or total conservative parotidectomy.

Adolescent↗

Liver cirrhosis induced by carbon tetrachloride and the effect of superoxide dismutase and xanthine oxidase inhibitor treatment.

Repeated administration of carbon tetrachloride (CCl4) induces liver cirrhosis, possibly because it involves the production of free radicals. In order to evaluate the effect of free radical scavengers such as superoxide dismutase (SOD) and allopurinol in the pathogenesis of liver cirrhosis, rats were subjected to repeated CCl4 administration with and without scavengers. Four groups of animals were studied: CCl4 plus SOD (group 1), CCl4 plus allopurinol (group 2), CCl4 alone (group 3) and olive oil (group 4, normal controls). Analysis of plasma and tissue concentrations of trace elements was performed and histopathological patterns were studied in all groups after 7 weeks of repeated intraperitoneal administration of the solutions. Plasma levels of zinc and selenium were significantly lower in all experimental groups, with reciprocal elevation of manganese and copper. Copper and manganese content in the liver tissue was significantly higher in all three experimental groups. The zinc content was elevated in groups receiving CCl4 alone (group 3) or with allopurinol (group 2). The liver selenium, however, was significantly lower in these two groups. The copper:zinc ratio for plasma was 0.78 in the control group, 1.6 in the CCl4 group, 1.3 in the allopurinol group and 1.5 in the SOD group. For liver tissue, the ratio was 0.07 for controls, 0.17 for CCl4, 0.11 for allopurinol and 0.28 for the SOD group. The changes in trace element content correlated with the severity of cellular damage observed microscopically in the liver. The higher the copper:zinc ratio, the more advanced and extensive was the microscopic evidence of liver injury after CCl4 challenge.

Allopurinol↗

Thyroid lobectomy for removal of a fish bone.

A 42-year-old female Jordanian patient presented with a history of sudden painful dysphagia following swallowing of a fish bone. Though soft tissue X-rays showed a foreign body in the neck, repeated oesophagoscopies failed to reveal it. Computed axial tomography was done and showed a fish bone embedded in the left thyroid lobe. Left thyroid lobectomy was carried out and the fish bone was seen within the lobe surrounded by an area of acute inflammation.

Adult↗