Biomedical subjects

A R Moossa

Publications and source records attributed to A R Moossa.

At least 181 records · Page 10Linked to original sources

PubMed1976

In situ kidney preservation for transplantation with use of profound hypothermia (5 to 20 degrees C.) with an intact circulation.

Twenty-seven anesthetized dogs were surface cooled at 4 to 6 degrees C. or 15 to 20 degrees C. Circulation was provided by the mechanical ventricular assist in 23 dogs. After 24 or 48 hours of in situ preservation, the kidneys were transplanted into the necks or iliac fossas of anephric recipients. Renal function was preserved in the cadaver for up to 48 hours at 15 to 20 degrees C. by maintaining a pulsatile circulation. Further cooling to 4 to 6 degrees C. caused progressive deterioration in renal function. The nonperfused kidneys kept in situ at 4 to 6 degrees C. did not produce any urine after transplantation. If the practical problems of total body cooling are solved, in situ preservation of multiple organs in the cadaver would increase the number of available organs for transplantation.

Animals↗

PubMed1976

Gastro-oesophageal reflux and hiatal hernia. A re-evaluation of current data and dogma.

Various methods of investigating and treating patients with gastro-oesophageal disorders are described and the rationale of current concepts is outlined. Emphasis is placed throughout on gastro-oesophageal reflux and its sequelae rather than on sliding hiatal hernias. Symptoms of gastro-oesophageal dysfunction can be misleading, and careful studies are essential in assessing its importance and the results of various modes of therapy.

Animals↗

PubMed1976

Effect of fifty percent small bowel resection on gastric secretory function in rhesus monkeys.

Basal acid output (BAO) and histamine-stimulated acid output (MAO) were studied in 11 fasting rhesus monkeys. Serum gastrin and gastric inhibitory polypeptide (GIP) were assayed in eight. Fifty percent distal small bowel resection was performed and the studies were repeated at 6 weeks and 6 months. Highly significant increases were seen in BAO (0.37 "/- 0.05 to 1.73 +/- 0.37 mEq. per hour; P less than 0.005) and MAO (1.7 +/- 0.22 to 3.21 +/- 0.45 mEq. per hour P less than 0.01) at 6 weeks. These levels persisted at 6 months. The ratio BAO:MAO increased throughout the experiment, the changes being significant at both time intervals. A significant rise was noted in the levels of both fasting serum gastrin (P less than 0.05) and GIP (P less than 0.01) during the early phase. By 6 months the levels of both hormones had fallen and were not significantly different from the control values. It was concluded that 50 percent small bowel resection causes a persistent increase in gastric acid secretion. No corresponding sustained change in serum gastrin or GIP occurs.

Animals↗

PubMed1976

Comparative value of four methods of investigating the pancreas.

In a prospective study for the diagnosis of pancreatic cancer, ultrasonography, radionuclide scanning, selective arteriography, and endoscopic retrograde cholangiopancreatography (ERCP) were compared. Eighty-nine consecutive patients were investigated; 58 underwent laparotomy, and 36 were found to have periampullary cancer; seven had other malignant tumors within the abdomen, and nine had pancreatitis on biopsy. Five had other benign disease, and there was one negative laparotomy. Thirty-one patients who did not have laparotomy have shown no evidence of cancer at one year follow-up. Ultrasonography was found to be more reliable than scan or arteriography in the detection and diagnosis of a mass in the pancreas. ERCP achieved the highest rate of correct definitive diagnosis.

Angiography↗

PubMed1975

Aorto-iliac reconstruction with special reference to the extraperitoneal approach.

We have used the extraperitoneal approach for aorto-iliac reconstruction for lower limb ischaemia in over 130 patients. The operative exposure is excellent. Operating time is shortened and the upset to the patient much less than in the transperitoneal approach. We now believe that the method is suitable for use in the majority of aorto-iliac reconstructions. Patency rate 4 years after surgery for claudication is 89 per cent.

Aorta, Abdominal↗

PubMed1975

Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum and rectosigmoid.

One hundred and fifty-two patients who underwent abdominoperineal resection for cancer of the rectum and rectosigmoid are reviewed. Six physicians were selected to predict which of these patients would have a local recurrence. All information available at the end of the operation was duplicated and submitted to the observers. None of the physicians was able to predict local recurrence significantly better than random. There were 31 local recurrences, i.e. an incidence of 20-4 per cent. Low level of tumour in the rectum, local spread into perirectal fat or serosa, lymph node involvement and age below 60 years at time of operation were the only factors that were statistically related to local recurrence. The strategy for careful follow-up of patients at risk is outlined and a plea is made for a controlled trial of postoperative radiotherapy.

Age Factors↗

PubMed1975

The continuing challenge of gallbladder cancer. Survey of thirty years' experience at the University of Chicago.

The current concepts of the etiologic factors and spread of carcinoma of the gallbladder are discussed. The experience at the university of Chicago with this condition over a period of thirty years is reviewed. Of eighty-two cases diagnosed during this time, 88 per cent of the patients died within one year of diagnosis and the five year survival rate was 5 per cent. The difficulties in diagnosis of cholecystic neoplasms are considered, and the possibility of increasing diagnostic accuracy by the use of celiac axis angiography, immunologic tests for tumor-associated antigens, peptide hormone assays, and cytologic study of duodenal juice is discussed. The place of palliative surgery in the management of cancer of the gallbladder is outlined. Means of improving the current high mortality of this condition are evaluated, and a plea is made for a controlled trial of the various forms of treatment that have been suggested.

Adult↗

PubMed1975

The effects of premedication drugs on the lower oesophageal high pressure zone and reflux status of rhesus monkeys and man.

Thirty-five human volunteers and eight Rhesus monkeys were studied with standard gastrooesophageal manometric techniqes and their reflux status was evaluated witha pH probe placed in the lower oesophagus. morphine sulphate, pethidine hydrochloride, or idazepam was given intravenously until drowsiness was induced. The manometric and pH studies were repeated. All three drugs decreased the lower oesophageal high pressure zone and increased the probability of relux in both monkeys and man. Thes findings are relevant in the preparation of patients for surgery since gastrooesophageal reflux and pulmonary aspiration may be a problen in the pre-and postoperative phases.

Animals↗

PubMed1975

Treatment of obstructing cancer of the colon and rectum.

A review was made of 128 patients who had obstructing cancer of the colon and rectum. About one-third of the patients had metastatic disease at the time of presentation. Primary resection carried an initial higher mortality rate than staged resection, but at one year and three years, no statistical difference can be found between the two procedures. There are high morbidity and mortality rates with all forms of treatment. A controlled comparative trial of primary and staged resection is recommended in the treatment of obstructing cancer of the colon and rectum.

Adult↗

PubMed1974