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Biomedical subjects

B Morag

Publications and source records attributed to B Morag.

At least 19 recordsLinked to original sources
PubMed1991

A radiometric assay for aspartoacylase activity in human fibroblasts: application for the diagnosis of Canavan's disease.

A new sensitive method for measuring aspartoacylase activity in human skin fibroblasts using [3H]N-acetyl-L-aspartic acid (NAA) is described. Optimal assay conditions and kinetic parameters for enzyme activity were determined. The enzyme was found to have maximal activity at pH 8.5, and the Michaelis constant for the substrate N-acetylaspartate was 1.8-2.0 mmol/l. Aspartoacylase activity in control cultured human fibroblasts was 9.2 +/- 1.8 nmol/h per mg protein, compared with 1.1 +/- 0.2 in seven Canavan patients and 3.5 +/- 0.9 in four patients' parents. This method for determining aspartoacylase activity is advantageous to the previously described spectrophotometric method since it is rapid, more sensitive and has less nonspecific interference. It is possible that application of this technique to cultured ammniotic and chorionic villi cells may be used for prenatal diagnosis of Canavan's disease.

Acetates↗
PubMed1991

Revascularisation for a poorly functioning solitary kidney.

Renovascular disease in a solitary kidney is a difficult and challenging problem. In six patients, with a mean age of 62 years, revascularisation was undertaken. In four of them, one to three attempts at PTA were made before the operation but all were unsuccessful. The preoperative mean serum creatine (Cr) was 3.52 mg% (range 2.5-5.5). The stenoses were caused by atherosclerosis in five cases and fibromuscular dysplasia (FMD) in one. Two methods of revascularisation were used: aortorenal bypass with saphenous vein (three patients) or PTFE (two patients), and transaortic renal endarterectomy with a venous patch (one patient). One patient with an aortic aneurysm underwent simultaneous aortic repair with a PTFE graft. There was no mortality or major complications in our series and no patient suffered acute tubular necrosis (ATN) after surgery. The mean follow-up period was 51 months (15-84 months). Postoperative Cr and blood pressure improved in all patients. Four patients no longer required any medication and the other two only needed reduced doses of antihypertensive drugs. Based on our experience of patients with poor single kidney function, we do not recommend PTA in this specific group of patients and suggest an aggressive surgical approach, which can effectively improve solitary kidney function, thus eliminating further haemodialysis.

Anastomosis, Surgical↗
PubMed1990

Aortobronchial fistula as a complication of surgery for correction of congenital aortic anomalies.

An aortobronchial fistula is a rare condition that is invariably fatal if not diagnosed and surgically treated. Aortic aneurysms, both atherosclerotic and infective, were the main causes in the originally described cases. However, thoracic cardiovascular surgery has recently become the predominant cause. The authors describe two such patients who presented 4 1/2 and 5 years after surgery for the correction of congenital anomalies. Both patients had severe hemoptysis, and angiography helped establish the diagnosis of an aortobronchial fistula. This diagnosis should be considered in patients with hemoptysis and a history of thoracic surgery.

Adult↗
PubMed1989

Femoral neuropathy: the role of computed tomography in diagnosis and management in 27 patients.

The computed tomography findings in 27 patients with an ultimate diagnosis of femoral neuropathy were reviewed. Haemorrhagic disorders were responsible for the neuropathy in 10 patients, neoplasia in eight, infection in five and in the remaining four patients no abnormality was noted on CT and the aetiology remained uncertain. Unilateral enlargement of the iliopsoas muscle or a soft tissue mass involving the iliopsoas compartment was noted in the 23 patients with positive studies. The exact nature of the mass could not be determined by CT alone, but, when considered together with clinical history and examination, a definitive diagnosis was possible in most instances. Whenever necessary, percutaneous needle biopsy or drainage was performed. Computed tomography should be performed at an early stage in all patients suspected of femoral neuropathy. It accurately demonstrates and delineates retroperitoneal masses causing this condition and allows further definitive diagnostic procedures such as biopsy or drainage to be performed when necessary.

Adolescent↗
PubMed1989

Errors and pitfalls in intraarterial thrombolytic therapy.

Sixty complications occurred during 138 courses of intraarterial thrombolytic therapy in 122 patients during a 5-year period. These complications were recorded and analyzed prospectively to identify underlying errors in management. There were 31 bleeding episodes, 15 vascular complications, and 14 other complications. Twelve of the bleeding episodes occurred at the puncture site, and 19 occurred at remote sites, accounting for six of the eight deaths in the series. Management errors were clearly identified in 27 of the 60 complications. The three following patterns of errors were recognized: (1) mismanagement of bleeding (12 instances), (2) wrong patient selection (nine instances), and (3) breach of the administration protocol (six instances). The group of 27 complications with underlying management errors included seven of the eight deaths in the present series. Efforts to prevent complications from thrombolytic therapy should concentrate on the specific patterns of management errors identified. This study indicates that low-dose intraarterial thrombolytic therapy is not a low-risk alternative to surgical intervention but should be viewed as a prelude or possible alternative to surgery in selected patients despite the risks involved.

Adolescent↗
PubMed1988

Functionally reversible hepatic arteriovenous fistulas during pregnancy in patients with hereditary hemorrhagic telangiectasia.

Two patients with hereditary hemorrhagic telangiectasia (HHT) who previously had only rare episodes of epistaxis had during pregnancy congestive heart failure and signs consistent with hepatic AV shunts. These were confirmed by angiography in one patient. After delivery the patients recovered spontaneously, and within six months congestive heart failure disappeared.

Adult↗
PubMed1988

Total femoral replacement.

Between 1973 and 1983, 19 patients with sarcoma of the femur were treated by adjuvant chemotherapy, excision of the entire femur, and replacement by a total femoral prosthesis. Five patients had excellent and nine had good functional results. Twelve patients died an average of 23 months after the procedure and seven are at present disease free. This limb-saving procedure permits rapid rehabilitation, prevents severe psychological problems, and improves the quality of life.

Adult↗
PubMed1987

Percutaneous transluminal angioplasty of the distal abdominal aorta and its bifurcation.

Percutaneous transluminal angioplasty (PTA) of stenotic lesions in the distal abdominal aorta and its bifurcation was performed in 14 patients, 6 of whom were women. The stenotic segment in the aorta or aortic bifurcation was usually the only significant lesion. The double-balloon technique was used in 12 patients via bilateral femoral artery catheterizations. In 2 other patients with aortic lesions, a single large balloon sufficed. Good results were achieved in all but 1 patient, with minor complications occurring in 3 instances. The follow-up period varied from 6 months to 5 years. We believe that PTA is the procedure of choice in treating localized lesions of the distal abdominal aorta and its bifurcation, especially when distal vessels are relatively uninvolved.

Adult↗
PubMed1987

Percutaneous transluminal recanalization of common iliac artery occlusions.

Percutaneous transluminal recanalization of occluded iliac arteries was attempted in 25 patients (26 limbs). In 22, successful recanalization was achieved, although 4 patients required additional surgical thrombectomy. The remaining 4 patients had surgical bypass procedures. The early and late results of percutaneous recanalization are presented as well as the technique used. We conclude that percutaneous recanalization of iliac occlusion is an effective procedure in the majority of cases. The option of surgical treatment remains viable when the percutaneous approach is unsuccessful.

Adult↗
PubMed1987

Polyarteritis nodosa and familial Mediterranean fever.

A 22-year-old familial Mediterranean fever (FMF) patient was hospitalized for continuous fever, myalgia, hypertension, vertigo and a petechial rash. Laboratory findings revealed hyperglobulinaemia, thrombocytosis and a leukaemoid reaction. While on steroid therapy the patient sustained a haemorrhage into a renal aneurysm which responded to gel foam embolization. After 12 months of follow-up his condition remained stable under treatment with cyclophosphamide, prednisone and antihypertensive medications. This case provides the fourth example of polyarteritis nodosa associated with FMF.

Abdomen↗
PubMed1986

Percutaneous transluminal angioplasty. A suggested method for analysis of clinical, arteriographic, and hemodynamic factors affecting the results of treatment.

Sixty-nine percutaneous transluminal angioplasties (PTAs) were performed in the iliac and the femoral arteries of 54 patients. The main factors that might affect the results were reviewed: associated diseases, severity of ischemic symptoms, location and type of lesions (stenosis or occlusion and their length), and presence of disease distal to the site dilated. The vascular status of the patients in our series was more severe than in most others. Improvement at follow-up (average 15 months) was maintained in 74% of 66 radiographically successful PTAs. Poor runoff was the only factor found to affect the outcome deleteriously. Intra-arterial pressure measurements performed during the procedure and vascular laboratory studies were most valuable in assessing immediate and long-term results. Wide variations in results of PTA published in the literature are due to differences in methods of selection, evaluation, and reporting. A plea is made for future presentations of PTA series in an analyzable and comparable way, including and correlating all relevant variables as in the model suggested by the present study.

Adult↗
PubMed1985

Persistent sciatic artery: a case report.

Persistence of the embryonic sciatic artery is a rare vascular anomaly with only 52 documented cases, of which only 19 had angiographic studies. We describe a patient with angiographic demonstration of persistence of a left sciatic artery associated with arterial anomalies of the opposite limb. The embryology radiological findings and clinical significance are discussed.

Angiography↗